Organization
CENTERWELL PHARMACY, INC.
Active
Other names
Humana Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN LYSINGER (VP)
(502) 580-2376
Entity
Organization
Contact information
Practice address
11240 BEACH BLVD, JACKSONVILLE, FL 32246-3802
(904) 380-0318
Mailing address
11240 BEACH BLVD, JACKSONVILLE, FL 32246-3802
(904) 380-0320
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH29426
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154401
PK
—
Enumeration date
10/05/2015
Last updated
02/24/2026
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