MEDICARE: WELLFOUNT CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy
2	183500000X	Pharmacist
3	333600000X	Pharmacy
4	3336L0003X	Long Term Care Pharmacy	60005933	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2025360	OTHER		PK
2	1560475	OTHER	IN	NCPDP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407877467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLFOUNT CORPORATION

Provider Business Mailing Address
First Line	:	5751 W 73RD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1741
Country	:	US
Telephone Number	:	317-524-1515
Fax Number	:	844-325-7228

Provider Business Practice Location Address
First Line	:	5751 W 73RD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-1741
Country	:	US
Telephone Number	:	317-524-1515
Fax Number	:	317-552-1101

Authorized Official
Title or Position	:	CONTROLLER
Name	:	JOHN SOLHAN
Credential	:
Telephone Number	:	317-524-1515

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	08/19/2019

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Directions to “WELLFOUNT CORPORATION ” Practice Location

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