Provider Demographics
NPI:1174659460
Name:HEALTH TEAM INC.
Entity Type:Organization
Organization Name:HEALTH TEAM INC.
Other - Org Name:ST JOHNS FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHAKAMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOHARNIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-962-6471
Mailing Address - Street 1:14514 RAMONA BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3305
Mailing Address - Country:US
Mailing Address - Phone:626-962-6471
Mailing Address - Fax:626-962-9674
Practice Address - Street 1:14514 RAMONA BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3305
Practice Address - Country:US
Practice Address - Phone:626-962-6471
Practice Address - Fax:626-962-9674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA4411103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy