Provider Demographics
NPI:1235216102
Name:HEALTHY PHARMACY INC
Entity Type:Organization
Organization Name:HEALTHY PHARMACY INC
Other - Org Name:CHENG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AGAPI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-281-9222
Mailing Address - Street 1:600 W MAIN ST
Mailing Address - Street 2:STE 106
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3300
Mailing Address - Country:US
Mailing Address - Phone:626-281-9222
Mailing Address - Fax:626-281-0551
Practice Address - Street 1:600 W MAIN ST
Practice Address - Street 2:STE 106
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3300
Practice Address - Country:US
Practice Address - Phone:626-281-9222
Practice Address - Fax:626-281-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY490523336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2001256OtherPK
CA6323050001Medicaid
CAPHA410030Medicaid
6323050001Medicare NSC