Healthcare Provider Details

I. General information

NPI: 1639005861
Provider Name (Legal Business Name): WELLFOCUS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2496 COLUMBIA DR STE A
DECATUR GA
30034-1769
US

IV. Provider business mailing address

2496 COLUMBIA DR STE A
DECATUR GA
30034-1769
US

V. Phone/Fax

Practice location:
  • Phone: 770-637-7600
  • Fax: 770-637-7602
Mailing address:
  • Phone:
  • 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: VIVEK PATEL
Title or Position: OWNER
Credential:
Phone: 224-544-0446