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General NPI Number Information
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NPI Number | 1962427450
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Entity Type | Organization
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Legal Business Name | CENTERWELL PHARMACY, INC.
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 301 NW 84TH AVE
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City | PLANTATION
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State | FL
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Zip | 33324-1807
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Country | US
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Telephone | 954-321-2682
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Fax | 954-321-2688
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Provider Business Mailing Address
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Address Line | 10749 MARKS WAY
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City | MIRAMAR
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State | FL
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Zip | 33025-3976
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Country | US
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Telephone | 800-526-1489
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Fax | 800-526-1491
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Authorized Official
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Title or Position | VP
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Name | SEAN LYSINGER
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Credential |
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Telephone | 502-580-2376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26432
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License Number State | FL
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