Provider Demographics
NPI:1164411518
Name:HEALTHMED PHARMACEUTICAL INC
Entity Type:Organization
Organization Name:HEALTHMED PHARMACEUTICAL INC
Other - Org Name:SPECIALIST MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-273-9829
Mailing Address - Street 1:421 E BEACH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-3103
Mailing Address - Country:US
Mailing Address - Phone:310-674-4432
Mailing Address - Fax:310-672-1069
Practice Address - Street 1:421 E BEACH AVE STE A
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-3103
Practice Address - Country:US
Practice Address - Phone:310-674-4432
Practice Address - Fax:310-672-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
CA545853336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2128694OtherPK