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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