Organization
HEALTHY KIDS RX LLC
Active
Organization
HEALTHY KIDS RX LLC
Active
Other names
HEALTHY KIDS RX
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH CHRISANTHUS (VP)
(724) 934-5439
Entity
Organization
Contact information
Practice address
10441 PERRY HWY, STE 16, WEXFORD, PA 15090-9292
(724) 934-5439
(724) 934-5442
Mailing address
10441 PERRY HWY, STE 16, WEXFORD, PA 15090-9292
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481757
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022628480001
—
PA
01
—
3989235
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2007
Last updated
04/09/2009
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