Healthcare Provider Details

I. General information

NPI: 1720004096
Provider Name (Legal Business Name): WELLS YEAGER BEST CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 N EARL AVE
LAFAYETTE IN
47904-2812
US

IV. Provider business mailing address

120 N 3RD ST
LAFAYETTE IN
47901
US

V. Phone/Fax

Practice location:
  • Phone: 765-447-1935
  • Fax: 765-447-2601
Mailing address:
  • Phone: 765-742-1016
  • Fax: 765-429-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number60002663A
License Number StateIN

VIII. Authorized Official

Name: MR. RAY DEGNER
Title or Position: HOME CARE MANAGER
Credential:
Phone: 765-447-1935