Organization
WELLCARE PHARMACY 2
Active
Organization
WELLCARE PHARMACY 2
Active
Other names
Wellcare Pharmacy 2
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LIU (PHARMACY MANAGER)
(267) 686-8800
Entity
Organization
Contact information
Practice address
1550 PRATT ST, FL 1, PHILADELPHIA, PA 19124-1923
(267) 686-8800
(267) 686-8745
Mailing address
1550 PRATT ST, FL 1, PHILADELPHIA, PA 19124-1923
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482580
PA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030380870001
—
PA
01
—
2153765
PK
—
Enumeration date
08/25/2015
Last updated
08/18/2025
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