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General NPI Number Information
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NPI Number | 1477895944
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Entity Type | Organization
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Legal Business Name | WELLCARE PHARMACY INC
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Dates
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Enumeration Date | 03/22/2013
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 2220 COTTMAN AVE FLOOR 1
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1203
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Country | US
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Telephone | 267-538-2685
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Fax | 267-538-2684
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Provider Business Mailing Address
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Address Line | 2220 COTTMAN AVE FLOOR 1
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1203
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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 | PHARMACY MANAGER
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Name | ZENGXING LI
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Credential |
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Telephone | 267-538-2685
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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 | PP482368
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License Number State | PA
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