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General NPI Number Information
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NPI Number | 1437825569
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Entity Type | Organization
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Legal Business Name | WELLS BROS. PHARMACY SERVICES VAN BUREN, LLC
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 1547 BROAD ST
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City | KEOSAUQUA
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State | IA
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Zip | 52565-1163
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Country | US
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Telephone | 319-293-7757
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Fax | 319-293-7741
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Provider Business Mailing Address
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Address Line | 1547 BROAD ST
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City | KEOSAUQUA
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State | IA
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Zip | 52565-1163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MYLO WELLS
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Credential | PHARMD
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Telephone | 641-208-6889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 333600000X
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Taxonomy Name | 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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 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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