Healthcare Provider Details

I. General information

NPI: 1598695223
Provider Name (Legal Business Name): KURE WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 LAKE MENDOCINO DR
UKIAH CA
95482-9401
US

IV. Provider business mailing address

1784 S MAIN ST
WILLITS CA
95490-4440
US

V. Phone/Fax

Practice location:
  • Phone: 707-459-4200
  • Fax:
Mailing address:
  • Phone: 707-459-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RUSSELL GREEN
Title or Position: OWNER
Credential:
Phone: 707-272-7805