Organization
IHS PHARMACY AND WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN WEEKS (CEO)
(937) 374-0899
Entity
Organization
Contact information
Practice address
100 N DETROIT ST, XENIA, OH 45385-2912
(937) 374-0899
(937) 374-0950
Mailing address
100 N DETROIT ST, XENIA, OH 45385-2912
(937) 374-0899
(937) 374-0950
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02-1374300
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021374300
STATE PHARMACY LICENSE #
OH
05
—
2411974
—
OH
01
—
3671840
NCPDP
—
01
—
36D1029562
CLIA
—
Enumeration date
02/02/2007
Last updated
03/07/2023
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