Provider Demographics
NPI:1710272646
Name:HEALTHY MEDS PHARMACY CORP
Entity Type:Organization
Organization Name:HEALTHY MEDS PHARMACY CORP
Other - Org Name:HEALTHY MEDS PHARMACY CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-404-6556
Mailing Address - Street 1:730 W HALLANDALE BEACH BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5300
Mailing Address - Country:US
Mailing Address - Phone:954-404-6556
Mailing Address - Fax:954-697-0107
Practice Address - Street 1:730 W HALLANDALE BEACH BLVD STE 105
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5300
Practice Address - Country:US
Practice Address - Phone:954-404-6556
Practice Address - Fax:954-697-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH255343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2130804OtherPK