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General NPI Number Information
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NPI Number | 1356219802
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Entity Type | Organization
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Legal Business Name | HEALING HAVEN RX, LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 520 SE 8TH AVE
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4844
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Country | US
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Telephone | 813-725-2498
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Fax |
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Provider Business Mailing Address
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Address Line | 520 SE 8TH AVE
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4844
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Country | US
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Telephone | 813-725-2498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KYLE TOMPKINS
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Credential | PHARMACY
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Telephone | 320-405-9504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835C0207X
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Taxonomy Name | Compounded Sterile Preparations Pharmacist
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License Number |
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License Number State |
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