| Organization Name: | HEALTH DIVERSITY LLC |
| NPI Number: | 1013329184 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GWENDOLYN GREEN (OWNER) |
| Mailing Address: | 610 Uptown Blvd Cedar Hill |
| State: | TX US |
| Postal Code: | 751043527 |
| Phone Number: | 4693376402 |
| Fax Number: | |
| NPI Enumeration Date: | 05/23/2014 |
| NPI Last Update Date: | 05/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835G0303X |
| License Number: | 43907 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Geriatric |
| Taxonomy Definition: | A pharmacist who is certified in geriatric pharmacy practice is designated as a |