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NPI Code Detail

MEDICARE: CENTERWELL PHARMACY, INC.

MEDICARE: CENTERWELL PHARMACY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0002XClinic Pharmacy
23336C0003XCommunity/Retail PharmacyPH26554FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12010160OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407871999
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTERWELL PHARMACY, INC.
Provider Business Mailing Address
First Line : 10749 MARKS WAY
Second Line :
City : MIRAMAR
State : FL
Zip : 33025-3976
Country : US
Telephone Number : 800-526-1489
Fax Number : 800-526-1491
Provider Business Practice Location Address
First Line : 9030 KIMBERLY BLVD
Second Line :
City : BOCA RATON
State : FL
Zip : 33434-2823
Country : US
Telephone Number : 561-470-5897
Fax Number : 561-482-5464
Authorized Official
Title or Position : VP
Name : SEAN LYSINGER
Credential :
Telephone Number : 502-580-2376
Provider Enumeration Date : 07/13/2006
Last Update Date : 02/24/2026

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