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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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1720598840
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 7527 STATE AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-2815
Country : US
Telephone Number : 913-335-6990
Fax Number :
Authorized Official
Title or Position : VP
Name : SEAN LYSINGER
Credential :
Telephone Number : 502-580-2376
Provider Enumeration Date : 10/03/2017
Last Update Date : 06/12/2025

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