Provider Demographics
NPI:1568556975
Name:HYGEIA HOLDINGS LLC
Entity Type:Organization
Organization Name:HYGEIA HOLDINGS LLC
Other - Org Name:THE MEDICINE SHOPPE PHARMACY #1850
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MINAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIRISTIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:727-501-0188
Mailing Address - Street 1:1555 E BAY DR
Mailing Address - Street 2:UNIT K
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1555 E BAY DR
Practice Address - Street 2:UNIT K
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-1005
Practice Address - Country:US
Practice Address - Phone:727-501-0188
Practice Address - Fax:727-501-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH211453336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL028418100Medicaid
FL028418101OtherMEDICAID DME
1009643OtherOTHER ID NUMBER-COMMERCIAL NUMBER
FLBH9131436OtherDEA #
FL028418101OtherMEDICAID DME