Healthcare Provider Details

I. General information

NPI: 1376349050
Provider Name (Legal Business Name): HEALTHY CHOICE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2025
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E SERENE AVE STE 107
LAS VEGAS NV
89123-3209
US

IV. Provider business mailing address

1850 E SERENE AVE STE 107
LAS VEGAS NV
89123-3209
US

V. Phone/Fax

Practice location:
  • Phone: 702-750-9955
  • Fax: 702-754-0445
Mailing address:
  • Phone: 702-750-9955
  • Fax: 702-754-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GIOVANNI BAYLE
Title or Position: OWNER
Credential:
Phone: 702-750-9955