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NPI Code Detail

MEDICARE: DR. KATHERINE ANNE WELLES PHARMD

MEDICARE: DR. KATHERINE ANNE WELLES PHARMD
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
1183500000XPharmacistPCT.0014876CT

General Provider Information

NPI Number : 1528684065
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE ANNE WELLES PHARMD
Provider Business Mailing Address
First Line : 178 FLANDERS RD
Second Line :
City : MYSTIC
State : CT
Zip : 06355-1504
Country : US
Telephone Number : 860-271-3657
Fax Number :
Provider Business Practice Location Address
First Line : 372 W MAIN ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-5415
Country : US
Telephone Number : 860-887-5970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2020
Last Update Date : 06/20/2020

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