# IHS PHARMACY AND WELLNESS CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205974391
- **Authorized official:** MR. STEPHEN WEEKS (CEO)
- **Authorized official phone:** (937) 374-0899

## Contact information

- **Practice address:** 100 N DETROIT ST, XENIA, OH 45385-2912
- **Practice address phone:** (937) 374-0899
- **Practice address fax:** (937) 374-0950
- **Mailing address:** 100 N DETROIT ST, XENIA, OH 45385-2912
- **Mailing address phone:** (937) 374-0899
- **Mailing address fax:** (937) 374-0950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 02-1374300 | OH | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 021374300 | STATE PHARMACY LICENSE \# | OH |
| 05 | — | 2411974 | — | OH |
| 01 | — | 3671840 | NCPDP | — |
| 01 | — | 36D1029562 | CLIA | — |