Organization
WELLNESS PHARMACY, INC
Active
Other names
Specialty Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA A PHAM (PRESIDENT/CEO)
(402) 304-7564
Entity
Organization
Contact information
Practice address
4640 CHAMPLAIN DR, 113, LINCOLN, NE 68521-4714
(402) 413-9950
(402) 413-9964
Mailing address
4640 CHAMPLAIN DR STE 113, LINCOLN, NE 68521-4714
(402) 413-9950
(402) 413-9964
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3100
NE
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026581700
—
NE
Enumeration date
05/12/2016
Last updated
12/11/2025
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