Organization
WELLNESS PHARMACY AND COMPOUNDING CENTER LLC
Active
Other names
Wellness Pharmacy and Compounding Center, Wellness Pharmacy and Compound
Organization subpart
No
Provider details
NPI number
Authorized official
TED JEFFERSON BOYLAN SINO (MANAGER)
(919) 964-5656
Entity
Organization
Contact information
Practice address
2601 BLUE RIDGE RD, RALEIGH, NC 27607
(919) 413-2120
(919) 964-5757
Mailing address
2601 BLUE RIDGE RD, RALEIGH, NC 27607-0111
(919) 964-5656
(919) 964-5757
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
13422
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528573623
—
NC
Enumeration date
12/12/2017
Last updated
03/10/2022
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