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Organization
HEALTH DIVERSITY LLC
Active
Organization
HEALTH DIVERSITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN GREEN PHARM D., RPH (OWNER)
(972) 291-8864
Entity
Organization
Contact information
Practice address
610 UPTOWN BLVD, CEDAR HILL, TX 75104-3527
(469) 337-6402
Mailing address
610 UPTOWN BLVD, CEDAR HILL, TX 75104-3527
(469) 337-6402
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43907
TX
1835G0303X
Geriatric Pharmacist
43907
TX
1835N1003X
Nutrition Support Pharmacist
43907
TX
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
43907
TX
1835P1200X
Pharmacotherapy Pharmacist
43907
TX
1835P1300X
Psychiatric Pharmacist
43907
TX
Other
Enumeration date
05/23/2014
Last updated
05/23/2014
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