Healthcare Provider Details

I. General information

NPI: 1477036499
Provider Name (Legal Business Name): HEALTHY RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3188 S BYRNE RD
TOLEDO OH
43614-5326
US

IV. Provider business mailing address

3188 S BYRNE RD
TOLEDO OH
43614-5326
US

V. Phone/Fax

Practice location:
  • Phone: 419-777-4566
  • Fax: 419-777-4007
Mailing address:
  • Phone: 419-777-4566
  • Fax: 419-777-4007

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: HASAN DOUEIK
Title or Position: OWNER
Credential: RPH
Phone: 419-777-4566