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General NPI Number Information
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NPI Number | 1962257683
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Entity Type | Organization
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Legal Business Name | WELLWISE PHARMACY INC.
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Dates
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Enumeration Date | 04/18/2024
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 2519 N FRAZIER ST STE 3200
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City | CONROE
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State | TX
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Zip | 77303-1683
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Country | US
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Telephone | 281-762-1809
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Fax | 281-238-5784
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Provider Business Mailing Address
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Address Line | 5522 DRYAD DR
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City | HOUSTON
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State | TX
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Zip | 77035-4330
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Country | US
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Telephone | 281-762-1809
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Fax | 281-238-5784
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Authorized Official
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Title or Position | OWNER/PIC
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Name | DR. DEMITRIUS ONUAGULUCHI
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Credential | PHARM.D.
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Telephone | 347-209-6409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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