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General NPI Number Information
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NPI Number | 1689250029
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Entity Type | Organization
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Legal Business Name | GETWELL PHARMACY, LLC
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 8857 GOODMAN RD STE D
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-2203
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Country | US
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Telephone | 662-655-1437
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Fax | 662-510-2197
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Provider Business Mailing Address
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Address Line | 5779 GETWELL RD BLDG B
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City | SOUTHAVEN
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State | MS
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Zip | 38672-6349
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Country | US
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Telephone | 662-655-1437
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAN CORDELL
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Credential |
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Telephone | 662-655-1437
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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 |
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License Number State |
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