Provider Demographics
NPI:1114631249
Name:YAHWEH HEALTH, LLC
Entity Type:Organization
Organization Name:YAHWEH HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-923-7717
Mailing Address - Street 1:20659 STONE OAK PKWY APT 1905
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7535
Mailing Address - Country:US
Mailing Address - Phone:210-923-7717
Mailing Address - Fax:210-923-3720
Practice Address - Street 1:2115 PLEASANTON RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1300
Practice Address - Country:US
Practice Address - Phone:210-923-7717
Practice Address - Fax:210-923-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34580OtherSTATE BOARD OF PHARMACY LICENSE