Organization Active NPI

Healed Pharmacy Inc

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1073338752
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HEALED PHARMACY INC
Practice address
828 Lexington Ave # 11
New York, NY 10065-7374
Phone
(212) 858-0100
Fax
(646) 329-5493
NPI assigned
Nov 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sam SweidanNPI 1619419074
Title
Owner
Phone
(212) 858-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

828 Lexington Ave # 11
New York, NY 10065-7374

Mailing address

828 Lexington Ave # 11
New York, NY 10065-7374
Phone (212) 858-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250509003104 NY DME Supplier - Pharmacy 6800317199 Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

828 Lexington Ave
#11
New York, NY 10065
Phone (212) 858-0100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1073338752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 LEXINGTON AVE # 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657374",
            "telephone_number": "212-858-0100",
            "fax_number": "646-329-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 LEXINGTON AVE # 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657374",
            "telephone_number": "212-858-0100",
            "fax_number": "646-329-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALED PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "SWEIDAN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-858-0100"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.