Provider Demographics
NPI:1427473222
Name:HYGEIA LTC CORP
Entity type:Organization
Organization Name:HYGEIA LTC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HASBUN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:323-263-4903
Mailing Address - Street 1:305 N SOTO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1862
Mailing Address - Country:US
Mailing Address - Phone:323-263-4903
Mailing Address - Fax:323-263-8550
Practice Address - Street 1:305 N SOTO ST
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1862
Practice Address - Country:US
Practice Address - Phone:323-263-4903
Practice Address - Fax:323-263-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY48217Medicaid
CA5946910001Medicare NSC