Healthy Living at 140 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HEALTHY LIVING AT 140 LLC

Doing business as

HEALTHY LIVING @ RANDOLPH PHARMACY

Practice address

140 Route 10 Ste 9
Randolph, NJ 07869-1542

Phone

(973) 620-9544

Fax

(973) 620-9545

NPI assigned

Jul 22, 2024

Organization subpart

No

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

Authorized official

Name

Amira Mekhail

Title

President

Phone

(973) 620-9544

Specialties & licenses 1

Addresses

Other names 1

• HEALTHY LIVING @ RANDOLPH PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1073341269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROUTE 10 STE 9",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691542",
            "telephone_number": "973-620-9544",
            "fax_number": "973-620-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ROUTE 10 STE 9",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691542",
            "telephone_number": "973-620-9544",
            "fax_number": "973-620-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING AT 140 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "MEKHAIL",
        "authorized_official_first_name": "AMIRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-620-9544"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHY LIVING @ RANDOLPH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEALTHY LIVING @ RANDOLPH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nicolas Joseph Hernandez, PT
• Carly H Herschman, LCSW
• Eric Scott Herschman, PSY.D.
• Susan Gail Herschman, PSY.D.

• Community/Retail Pharmacy in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.