Organization
WELLS SPECIALTY PHARMACY
Active
Other names
Pharm-EZ Medical LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD TOMLINSON (VICE PRESIDENT OF OPERATIONS)
(407) 383-2004
Entity
Organization
Contact information
Practice address
803 SOUTH ORLANDO AVENUE, SUITE D, WINTER PARK, FL 32789
(407) 965-3980
(407) 965-2978
Mailing address
803 SOUTH ORLANDO AVENUE, SUITE D, WINTER PARK, FL 32789
(407) 965-3980
(407) 965-2978
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25780
FL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004633400
—
FL
01
—
2132816
PK
—
Enumeration date
11/22/2011
Last updated
04/06/2016
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