Organization
WELLCARE PHARMACY 4 LLC
Active
Other names
Wellcare Pharmacy 4
Organization subpart
No
Provider details
NPI number
Authorized official
ZENGXING LI (PRESIDENT)
(267) 488-1099
Entity
Organization
Contact information
Practice address
600 WASHINGTON AVE, UNIT 12, PHILADELPHIA, PA 19147-4836
(267) 488-1099
(267) 488-1098
Mailing address
600 WASHINGTON AVE, UNIT 12, PHILADELPHIA, PA 19147-4836
(267) 488-1099
(267) 488-1098
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482786
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177796
PK
—
Enumeration date
05/15/2018
Last updated
07/19/2018
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