Provider Demographics
NPI:1902138225
Name:HEALTHY SOCIETY LLC
Entity Type:Organization
Organization Name:HEALTHY SOCIETY LLC
Other - Org Name:HIGH STREET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:SANDHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:YARLAGADDA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:732-425-4842
Mailing Address - Street 1:22 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1702
Mailing Address - Country:US
Mailing Address - Phone:609-267-6000
Mailing Address - Fax:609-267-6550
Practice Address - Street 1:22 HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1702
Practice Address - Country:US
Practice Address - Phone:609-267-6000
Practice Address - Fax:609-267-6550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY SOCIETY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-11
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007014003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123950OtherPK