Provider Demographics
NPI:1356092043
Name:WHOLE & HAPPY LIVING
Entity Type:Organization
Organization Name:WHOLE & HAPPY LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:PRUDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:801-547-7462
Mailing Address - Street 1:2362 21ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-5878
Mailing Address - Country:US
Mailing Address - Phone:801-547-7462
Mailing Address - Fax:
Practice Address - Street 1:1530 GREENVIEW DR SW STE 203
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-4327
Practice Address - Country:US
Practice Address - Phone:507-258-3092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy