Healthcare Provider Details

I. General information

NPI: 1407877467
Provider Name (Legal Business Name): WELLFOUNT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5751 W 73RD ST
INDIANAPOLIS IN
46278-1741
US

IV. Provider business mailing address

5751 W 73RD ST
INDIANAPOLIS IN
46278-1741
US

V. Phone/Fax

Practice location:
  • Phone: 317-524-1515
  • Fax: 317-552-1101
Mailing address:
  • Phone: 317-524-1515
  • Fax: 844-325-7228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number60005933
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN SOLHAN
Title or Position: CONTROLLER
Credential:
Phone: 317-524-1515