Healthy Life Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HEALTHY LIFE PHARMACY LLC

Practice address

401 Center St
Bismarck, MO 63624-9619

Phone

(573) 734-8588

Fax

(888) 626-5925

NPI assigned

Aug 4, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Laura E Haynes, PHARMDNPI 1013372952

Title

Owner

Phone

(573) 734-8588

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthy Life Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Tax ID family

Healthy Life Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Healthy Life Pharmacy LLC

  • Long Term Care Pharmacy
  • Bismarck, MO
  • NPI 1134812282
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Healthy Life Pharmacy LLC

  • Long Term Care Pharmacy
  • Bismarck, MO
  • NPI 1134812282
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura E Haynes, PHARMD

  • Pharmacist
  • Bismarck, MO
  • NPI 1013372952
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1619604154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 W RIDGE RD",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636288720",
            "telephone_number": "314-803-2352",
            "fax_number": "888-626-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CENTER ST",
            "city": "BISMARCK",
            "state": "MO",
            "postal_code": "636249619",
            "telephone_number": "573-734-8588",
            "fax_number": "888-626-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-734-8588",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI FOR LAURA HAYNES",
            "identifier": "1013372952",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Life Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthy Life Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colonial Retirement Center Inc.
• Victoria Nicole Eftink, M.A. CCC-SLP
• Kelley B Gray
• Laura E Haynes, PHARMD
• Healthy Life Pharmacy LLC
• Andrea M Kellerman
• Sheila Jane Reynolds-Dempsey
• Kimberly Irene Weiss, APRN, FNP-C

• All providers in Bismarck, MO
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.