Organization
THE WELLNESS STORE, INC.
Active
Other names
Wellspring Custom Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES BRADLEY ROSEBOROUGH R.PH. (PRESIDENT)
(419) 756-2559
Entity
Organization
Contact information
Practice address
2291 W 4TH ST, SUITE A, MANSFIELD, OH 44906-1261
(419) 756-2559
(419) 756-3135
Mailing address
2291 W 4TH ST, SUITE A, MANSFIELD, OH 44906-1261
(419) 756-2559
(419) 756-3135
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
OH
Other
Enumeration date
06/01/2007
Last updated
08/22/2020
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