Provider Demographics
NPI:1760085880
Name:EVEXIA HEALTH
Entity Type:Organization
Organization Name:EVEXIA HEALTH
Other - Org Name:INOVIA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWICH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH EMBA
Authorized Official - Phone:661-829-7861
Mailing Address - Street 1:PO BOX 21046
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1046
Mailing Address - Country:US
Mailing Address - Phone:661-829-7861
Mailing Address - Fax:661-829-7862
Practice Address - Street 1:9902 BRIMHALL RD STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2801
Practice Address - Country:US
Practice Address - Phone:661-829-7861
Practice Address - Fax:661-829-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA58017OtherSTATE LICENSE
FI0053417OtherDEA