Organization
HAYWOOD RX, LLC DBA OPTIMUM WELLNESS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ALLEN HAYWOOD RPH (OWNER/MANAGER)
(812) 457-1204
Entity
Organization
Contact information
Practice address
8900 RUFFIAN LN, NEWBURGH, IN 47630-3424
(812) 457-1204
Mailing address
8900 RUFFIAN LN, NEWBURGH, IN 47630-3424
(812) 457-1204
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
26020577
IN
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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