Provider Demographics
NPI:1568234771
Name:HEALTHY LIFE RX LLC.
Entity Type:Organization
Organization Name:HEALTHY LIFE RX LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MYSHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:POLK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-229-9802
Mailing Address - Street 1:2205 N MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4279
Mailing Address - Country:US
Mailing Address - Phone:281-741-2821
Mailing Address - Fax:281-741-2859
Practice Address - Street 1:2205 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4279
Practice Address - Country:US
Practice Address - Phone:281-741-2821
Practice Address - Fax:281-741-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy