Organization
HAYWOOD RX LLC
Active
Other names
Optimum Wellness Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HAYWOOD (OWER/RPH)
(812) 518-3428
Entity
Organization
Contact information
Practice address
8900 RUFFIAN LN, NEWBURGH, IN 47630-3424
(812) 518-3428
(812) 518-3430
Mailing address
8900 RUFFIAN LN, NEWBURGH, IN 47630-3424
(812) 518-3428
(812) 518-3430
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2156160
PK
—
Enumeration date
11/09/2015
Last updated
03/31/2016
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