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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
12602 TOEPPERWEIN RD, SUITE 100, LIVE OAK, TX 78233-3269
(210) 672-6510
Mailing address
12602 TOEPPERWEIN RD, SUITE 100, LIVE OAK, TX 78233-3269
(210) 672-6510

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
30954
TX
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2162396
PK
Enumeration date
08/05/2016
Last updated
05/06/2026
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