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General NPI Number Information
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NPI Number | 1609202597
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Entity Type | Organization
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Legal Business Name | HEALING PHARMACY
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 17860 SE 109TH AVE STE 616A
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8909
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Country | US
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Telephone | 352-693-2773
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Fax | 352-693-2806
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Provider Business Mailing Address
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Address Line | 17860 SE 109TH AVE STE. 616A
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8911
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Country | US
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Telephone | 352-693-2773
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Fax | 352-693-2806
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Authorized Official
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Title or Position | OWNER, PIC
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Name | SOBHY NADA
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Credential | RPH
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Telephone | 561-758-6928
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26807
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License Number State | FL
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