Healthcare Provider Details

I. General information

NPI: 1679857924
Provider Name (Legal Business Name): HEALTH & WELLNESS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 BLAZER PKWY STE 202
DUBLIN OH
43017-3376
US

IV. Provider business mailing address

5050 BLAZER PKWY SUITE 202
DUBLIN OH
43017-3361
US

V. Phone/Fax

Practice location:
  • Phone: 888-661-4497
  • Fax: 888-661-4497
Mailing address:
  • Phone: 888-661-4497
  • Fax: 888-661-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022126300
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DARRELL BRYANT
Title or Position: OWNER, PIC
Credential: RPH
Phone: 614-530-0698