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Organization
WELLS PHARMACY NETWORK LLC
Active
Organization
WELLS PHARMACY NETWORK LLC
Active
Other names
Wells Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WILBUR (PRESIDENT)
(561) 793-1568
Entity
Organization
Contact information
Practice address
11120 S CROWN WAY STE 11, WELLINGTON, FL 33414-8718
(561) 793-1568
(561) 793-1570
Mailing address
11120 S CROWN WAY, SUITE 11, WELLINGTON, FL 33414-8718
(561) 793-1568
(561) 793-1570
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PH25799
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5708435
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/21/2011
Last updated
10/19/2012
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