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General NPI Number Information
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NPI Number | 1164939195
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Entity Type | Organization
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Legal Business Name | HEALTHY HEIGHTS PHARMACY INC
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 1370 SAINT NICHOLAS AVE STORE #2
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City | NEW YORK
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State | NY
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Zip | 10033-6227
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Country | US
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Telephone | 212-928-1999
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Fax | 212-928-1995
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Provider Business Mailing Address
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Address Line | 1370 ST NICHOLAS AVE STORE #2
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City | MANHATTAN
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State | NY
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Zip | 10033
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Country | US
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Telephone | 212-928-1999
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Fax | 212-928-1995
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN MUSHEYEV
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Credential |
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Telephone | 212-928-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 035993
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License Number State | NY
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