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General NPI Number Information
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NPI Number | 1700639432
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Entity Type | Organization
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Legal Business Name | HEALTH GLOW, INC.
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 25381 ALICIA PKWY STE U
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4983
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Country | US
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Telephone | 949-800-9555
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Fax | 949-346-9150
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Provider Business Mailing Address
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Address Line | 25381 ALICIA PKWY STE U
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4983
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Country | US
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Telephone | 949-800-9555
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Fax | 949-346-9150
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Authorized Official
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Title or Position | CEO
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Name | ROYA AGAHI
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Credential |
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Telephone | 949-800-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail 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 | 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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