Healthcare Provider Details
I. General information
NPI: 1063087195
Provider Name (Legal Business Name): HAPPY MEDS LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2021
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5910 WAXHAW HWY 75 SUITE A
MINERAL SPRINGS NC
28108
US
IV. Provider business mailing address
PO BOX 128
MINERAL SPRINGS NC
28108-0128
US
V. Phone/Fax
- Phone: 704-256-3228
- Fax: 704-256-1820
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JACOB
T
ABRAHAM
Title or Position: PHARMACY MANAGER
Credential: R.PH
Phone: 704-719-0679