Healthcare Provider Details

I. General information

NPI: 1245878867
Provider Name (Legal Business Name): WELLS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 N LITCHFIELD RD
GOODYEAR AZ
85338-1227
US

IV. Provider business mailing address

247 N LITCHFIELD RD
GOODYEAR AZ
85338-1227
US

V. Phone/Fax

Practice location:
  • Phone: 623-932-3040
  • Fax: 623-932-3961
Mailing address:
  • Phone: 623-932-3040
  • Fax: 623-932-3961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL FRANK KURTIS
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 623-932-3040