Provider Demographics
NPI:1851000285
Name:HEALTHY U RX INC.
Entity Type:Organization
Organization Name:HEALTHY U RX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JADA
Authorized Official - Middle Name:RASHON
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-472-7881
Mailing Address - Street 1:201 S WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-2515
Mailing Address - Country:US
Mailing Address - Phone:574-472-7881
Mailing Address - Fax:574-586-5257
Practice Address - Street 1:405 E DUBAIL ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614
Practice Address - Country:US
Practice Address - Phone:574-393-9650
Practice Address - Fax:574-393-9651
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY U RX INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300031579Medicaid