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General NPI Number Information
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NPI Number | 1821631672
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING PHARMACY
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 3717 N. SHARON AMITY ROAD SUITE C
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City | CHARLOTTE
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State | NC
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Zip | 28205
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Country | US
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Telephone | 980-819-5648
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Fax | 980-819-5673
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Provider Business Mailing Address
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Address Line | 3717 N. SHARON AMITY RD SUITE C
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City | CHARLOTTE
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State | NC
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Zip | 28205-5815
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Country | US
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Telephone | 980-819-5648
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Fax | 980-819-5673
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. MIHRETEAB TEWOLDE TEWOLDE
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Credential | PHARMD
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Telephone | 319-341-9008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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