# WELLNESS 1 PHARMACY- WEST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WELLNESS1PHARMACY-WEST CARROLLTON SUITE B
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710429709
- **Authorized official:** KIMBERLY BOULTON RPH (MANAGER)
- **Authorized official phone:** (937) 384-7777

## Contact information

- **Practice address:** 2092 S ALEX RD STE B, SUITE B, WEST CARROLLTON, OH 45449-2491
- **Practice address phone:** (937) 384-7777
- **Practice address fax:** (937) 384-7778
- **Mailing address:** 2092 S ALEX RD STE B, SUITE B, WEST CARROLLTON, OH 45449-2491
- **Mailing address phone:** (937) 384-7778
- **Mailing address fax:** (937) 384-7778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PSNH.022653400- | OH | Yes |

## Other

- **Enumeration date:** 11/08/2016
- **Last updated:** 07/19/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2166154 | PK | — |