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General NPI Number Information
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NPI Number | 1780796615
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Entity Type | Organization
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Legal Business Name | WELLS SPECIALTY PHARMACY INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3796 HOWELL BRANCH RD
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City | WINTER PARK
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State | FL
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Zip | 32792-1740
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Country | US
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Telephone | 407-915-3360
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Fax | 407-386-3082
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Provider Business Mailing Address
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Address Line | 3796 HOWELL BRANCH RD
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City | WINTER PARK
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State | FL
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Zip | 32792-1740
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Country | US
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Telephone | 407-671-8070
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Fax |
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Authorized Official
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Title or Position | VP CLINICAL OPERATIONS AND SERVICES
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Name | MARY JO HEGLUND
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Credential |
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Telephone | 847-331-1449
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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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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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