Provider Demographics
NPI:1033424478
Name:HEALTHY MEDS LLC
Entity Type:Organization
Organization Name:HEALTHY MEDS LLC
Other - Org Name:HEALTHY MEDS, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAQUINTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYPPOLITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-362-4738
Mailing Address - Street 1:9021 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4676
Mailing Address - Country:US
Mailing Address - Phone:954-362-4738
Mailing Address - Fax:954-362-4739
Practice Address - Street 1:9021 TAFT ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-4676
Practice Address - Country:US
Practice Address - Phone:954-362-4738
Practice Address - Fax:954-362-4739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
FLPH247813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5701215OtherNCPDP PROVIDER IDENTIFICATION NUMBER