Provider Demographics
NPI:1730411836
Name:HEALTH VENTURES INC
Entity type:Organization
Organization Name:HEALTH VENTURES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP HEALTH VENTURES, INC.
Authorized Official - Prefix:
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:PROSPER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:510-655-4000
Mailing Address - Street 1:PO BOX 742432
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-2432
Mailing Address - Country:US
Mailing Address - Phone:510-204-6550
Mailing Address - Fax:
Practice Address - Street 1:2001 DWIGHT WAY RM 1380D
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2608
Practice Address - Country:US
Practice Address - Phone:510-204-6550
Practice Address - Fax:510-204-5895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123949OtherPK