Provider Demographics
NPI:1235731498
Name:LIVEWELL INTERNATIONAL HEALTH, INC.
Entity Type:Organization
Organization Name:LIVEWELL INTERNATIONAL HEALTH, INC.
Other - Org Name:HAPPY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-599-4242
Mailing Address - Street 1:4070 STATE HWY 121 STE 436
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010
Mailing Address - Country:US
Mailing Address - Phone:469-599-4242
Mailing Address - Fax:
Practice Address - Street 1:4070 STATE HWY 121 STE 436
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010
Practice Address - Country:US
Practice Address - Phone:469-599-4242
Practice Address - Fax:469-809-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150375Medicaid