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General NPI Number Information
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NPI Number | 1346951480
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Entity Type | Organization
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Legal Business Name | REPLENISH WELLNESS CONSULTING LLC
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1 OLD COUNTRY RD LL11
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City | CARLE PLACE
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State | NY
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Zip | 11514-1801
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Country | US
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Telephone | 516-287-2002
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Fax |
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Provider Business Mailing Address
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Address Line | 1 OLD COUNTRY RD LL11
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City | CARLE PLACE
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State | NY
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Zip | 11514-1801
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Country | US
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Telephone | 516-287-2002
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Fax | 516-279-4929
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALEXANDRA SHELON
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Credential | RPH
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Telephone | 917-696-3200
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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 |
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License Number State |
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Taxonomy #2
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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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