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General NPI Number Information
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NPI Number | 1558704718
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Entity Type | Organization
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Legal Business Name | GET WELL PHARMACY LLC
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 646 BLUE HILL AVE
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City | DORCHESTER
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State | MA
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Zip | 02121-3213
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Country | US
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Telephone | 617-533-7232
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Fax |
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Provider Business Mailing Address
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Address Line | 646 BLUE HILL AVE
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City | DORCHESTER
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State | MA
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Zip | 02121-3213
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Country | US
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Telephone | 617-533-7232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DONNA NEVAREZ
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Credential |
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Telephone | 617-533-7232
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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 | DS89862
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License Number State | MA
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