Provider Demographics
NPI:1285670679
Name:EASTWIND PARTNERS INC
Entity Type:Organization
Organization Name:EASTWIND PARTNERS INC
Other - Org Name:HEALTHY FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:323-582-5284
Mailing Address - Street 1:7932 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6804
Mailing Address - Country:US
Mailing Address - Phone:323-582-5284
Mailing Address - Fax:323-582-5288
Practice Address - Street 1:7932 SEVILLE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6804
Practice Address - Country:US
Practice Address - Phone:323-582-5284
Practice Address - Fax:323-582-5288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
CAPHY470483336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12855670679Medicaid
5617963OtherNCPDP PROVIDER IDENTIFICATION NUMBER
5617963OtherNCPDP PROVIDER IDENTIFICATION NUMBER