Provider Demographics
NPI:1083255418
Name:WELLNESS FAMILY PHARMACY
Entity Type:Organization
Organization Name:WELLNESS FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-937-1404
Mailing Address - Street 1:3250 CHICHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER CHICHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19061-3250
Mailing Address - Country:US
Mailing Address - Phone:610-234-2922
Mailing Address - Fax:610-569-9214
Practice Address - Street 1:3250 CHICHESTER AVE
Practice Address - Street 2:
Practice Address - City:UPPER CHICHESTER
Practice Address - State:PA
Practice Address - Zip Code:19061-3250
Practice Address - Country:US
Practice Address - Phone:610-234-2922
Practice Address - Fax:610-569-9214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy