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
420 S NOVA RD STE 4/5, ORMOND BEACH, FL 32174-0410
(386) 281-6633
Mailing address
420 S NOVA RD STE 4/5, ORMOND BEACH, FL 32174-0410
(786) 514-3927
(386) 615-8438
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155150
PK
—
Enumeration date
11/13/2015
Last updated
02/24/2026
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