Healthcare Provider Details

I. General information

NPI: 1528387164
Provider Name (Legal Business Name): HEALTHWAYS WORLDWIDE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 NEPTUNE AVE
BROOKLYN NY
11235-6375
US

IV. Provider business mailing address

225 NEPTUNE AVE
BROOKLYN NY
11235-6375
US

V. Phone/Fax

Practice location:
  • Phone: 718-513-4821
  • Fax: 718-513-4821
Mailing address:
  • Phone: 718-513-4821
  • Fax: 718-513-4821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number030364
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PERVEZ SIDDIQUI
Title or Position: SUPERVISING PHARMACIST
Credential:
Phone: 718-513-4821