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General NPI Number Information
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NPI Number | 1346631645
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Entity Type | Organization
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Legal Business Name | HEALING HEALTH PHARMACY INC
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 3330 W 177TH ST SUITE 3E
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City | HAZEL CREST
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State | IL
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Zip | 60429-2184
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Country | US
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Telephone | 708-991-2249
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Fax | 708-991-2150
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Provider Business Mailing Address
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Address Line | 3330 W 177TH ST SUITE 3E
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City | HAZEL CREST
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State | IL
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Zip | 60429-2184
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Country | US
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Telephone | 708-991-2249
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Fax | 708-991-2150
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Authorized Official
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Title or Position | PHARMACIST
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Name | VIVEK BRAHMBHATT
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Credential |
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Telephone | 708-991-2249
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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 | 054018978
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License Number State | IL
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