Healthcare Provider Details

I. General information

NPI: 1760085880
Provider Name (Legal Business Name): EVEXIA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 03/07/2023
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9902 BRIMHALL RD STE 100
BAKERSFIELD CA
93312-2801
US

IV. Provider business mailing address

PO BOX 21046
BAKERSFIELD CA
93390-1046
US

V. Phone/Fax

Practice location:
  • Phone: 661-829-7861
  • Fax: 661-829-7862
Mailing address:
  • Phone: 661-829-7861
  • Fax: 661-829-7862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMER JAWICH
Title or Position: CFO
Credential: RPH EMBA
Phone: 661-829-7861