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General NPI Number Information
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NPI Number | 1356269518
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Entity Type | Organization
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Legal Business Name | WELLINGTON PHARMACY INC
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 2201 WILTON DR
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City | WILTON MANORS
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State | FL
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Zip | 33305-2140
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Country | US
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Telephone | 954-545-2355
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Fax | 844-826-3873
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Provider Business Mailing Address
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Address Line | 2201 WILTON DR
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City | WILTON MANORS
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State | FL
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Zip | 33305-2140
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Country | US
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Telephone | 954-545-2355
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Fax | 844-826-3873
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Authorized Official
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Title or Position | CFO
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Name | JACOB DAVID VANDEVENTER
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Credential | PHARMD
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Telephone | 813-780-7216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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