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General NPI Number Information
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NPI Number | 1407463243
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Entity Type | Individual
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Provider Name | THOMAS KENNEDY WELLS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 2520 CUTHBERTSON RD
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City | WAXHAW
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State | NC
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Zip | 28173-7441
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Country | US
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Telephone | 704-627-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 335 DOGGETT ST APT 130
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City | CHARLOTTE
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State | NC
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Zip | 28203-6411
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Country | US
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Telephone | 704-989-4364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 29920
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42492
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License Number State | SC
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