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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