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
4302 W BUCKEYE RD, PHOENIX, AZ 85043-4904
(800) 379-0092
(800) 379-7617
Mailing address
4302 W BUCKEYE RD, PHOENIX, AZ 85043-4904
(800) 379-0092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
4370
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991956
PK
—
Enumeration date
06/08/2006
Last updated
02/24/2026
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