Organization
HEALTHY LIFE PHARMACY LLC
Active
Other names
Healthy Life Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA E HAYNES (OWNER/OPERATOR/SOLE MANAGING MEMBER)
(573) 734-8588
Entity
Organization
Contact information
Practice address
1013 CEDAR ST, STE B, BISMARCK, MO 63624
(573) 734-8588
Mailing address
1004 W RIDGE RD, BONNE TERRE, MO 63628-8720
(314) 803-2352
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013372952
INDIVIDUAL PROVIDER NPI FOR LAURA HAYNES
—
Enumeration date
08/04/2022
Last updated
08/15/2024
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