Healthcare Provider Details

I. General information

NPI: 1922485259
Provider Name (Legal Business Name): THE HEALTHY CHOICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 1ST ST
MONTGOMERY CITY MO
63361-2550
US

IV. Provider business mailing address

111 E 1ST ST
MONTGOMERY CITY MO
63361-2550
US

V. Phone/Fax

Practice location:
  • Phone: 573-564-3214
  • Fax: 573-564-3216
Mailing address:
  • Phone: 573-564-3214
  • Fax: 573-564-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number102389
License Number StateMO

VIII. Authorized Official

Name: LONDA Y SWOBODA
Title or Position: FNP
Credential:
Phone: 573-564-3214