Provider Demographics
NPI:1902789928
Name:HALO HEALTH PHARMACY INCORPORATED
Entity type:Organization
Organization Name:HALO HEALTH PHARMACY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-873-5173
Mailing Address - Street 1:459 E 149TH ST STE A104
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-1789
Mailing Address - Country:US
Mailing Address - Phone:212-381-8350
Mailing Address - Fax:212-381-8351
Practice Address - Street 1:459 E 149TH ST STE A104
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1789
Practice Address - Country:US
Practice Address - Phone:212-381-8350
Practice Address - Fax:212-381-8351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy