Organization
CENTERWELL PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN LYSINGER (VP)
(502) 580-2376
Entity
Organization
Contact information
Practice address
4078 S RIDGEWOOD AVE, PORT ORANGE, FL 32127-4501
(386) 241-1544
Mailing address
4078 S RIDGEWOOD AVE, PORT ORANGE, FL 32127-4501
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/12/2022
Last updated
06/12/2025
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