Provider Demographics
NPI:1356884670
Name:HEALTHYBENEFITSRX
Entity type:Organization
Organization Name:HEALTHYBENEFITSRX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:AKINWUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUSOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-951-1002
Mailing Address - Street 1:2013 STATE ROUTE 27
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3838
Mailing Address - Country:US
Mailing Address - Phone:732-951-1002
Mailing Address - Fax:732-951-1005
Practice Address - Street 1:2013 STATE ROUTE 27
Practice Address - Street 2:SUITE 1
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3838
Practice Address - Country:US
Practice Address - Phone:732-951-1002
Practice Address - Fax:732-951-1005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336M0002X, 332B00000X, 333600000X, 3336L0003X
NJ28RS007545003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order PharmacyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0581976Medicaid
2167914OtherPK