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General NPI Number Information
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NPI Number | 1275754798
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Entity Type | Organization
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Legal Business Name | WELLRX LLC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 200 E WILLOW AVE STE 100
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City | WHEATON
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State | IL
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Zip | 60187-5463
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Country | US
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Telephone | 877-629-4446
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Fax | 877-599-0139
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Provider Business Mailing Address
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Address Line | 200 E WILLOW AVE STE 100
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City | WHEATON
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State | IL
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Zip | 60187-5463
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Country | US
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Telephone | 877-629-4446
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Fax | 877-599-0139
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | SCOTT LUCKOW
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Credential | PHARMD
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Telephone | 877-629-4446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054002067
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 54020427
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 54020427
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 54020427
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License Number State | IL
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