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General NPI Number Information
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NPI Number | 1952351637
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Entity Type | Organization
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Legal Business Name | IHS PHARMACY AND WELLNESS CTR LLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 77 S CENTRAL AVE
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City | FAIRBORN
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State | OH
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Zip | 45324-4716
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Country | US
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Telephone | 937-482-0328
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Fax | 937-482-0342
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Provider Business Mailing Address
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Address Line | 77 S CENTRAL AVE
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City | FAIRBORN
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State | OH
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Zip | 45324-4716
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Country | US
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Telephone | 937-482-0328
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Fax | 937-482-0342
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN WEEKS
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Credential | RPH
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Telephone | 513-257-5309
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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 | 021584000
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License Number State | OH
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