Organization
JL WELLNESS PHARMACY, LLC
Active
Organization
JL WELLNESS PHARMACY, LLC
Active
Other names
Agape Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN PICCHI (OFFICER)
(972) 364-1793
Entity
Organization
Contact information
Practice address
3030 TOWNE CENTRE DR STE B, MESQUITE, TX 75150-4134
(972) 364-1793
(972) 364-1916
Mailing address
3030 TOWNE CENTRE DR STE B, MESQUITE, TX 75150-4134
(972) 364-1793
(972) 364-1916
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
S1545
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
1000726
TX
3336C0003X
Community/Retail Pharmacy
Primary
27232
TX
335E00000X
Prosthetic/Orthotic Supplier
S1545
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5901649
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/05/2010
Last updated
03/20/2018
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