Provider Demographics
NPI:1669122461
Name:E.V.A. HEALTH LLC
Entity type:Organization
Organization Name:E.V.A. HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, APH
Authorized Official - Phone:626-261-4400
Mailing Address - Street 1:457 S CITRUS AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2928
Mailing Address - Country:US
Mailing Address - Phone:626-261-4400
Mailing Address - Fax:
Practice Address - Street 1:457 S CITRUS AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2928
Practice Address - Country:US
Practice Address - Phone:626-261-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA55516OtherSTATE PHARMACY LICENSE