Provider Demographics
NPI:1184639791
Name:SCHAEFER DRUGS OF WELLINGTON INC
Entity Type:Organization
Organization Name:SCHAEFER DRUGS OF WELLINGTON INC
Other - Org Name:SCHAEFER DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-793-0151
Mailing Address - Street 1:12797 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4763
Mailing Address - Country:US
Mailing Address - Phone:561-793-0151
Mailing Address - Fax:561-753-3498
Practice Address - Street 1:12797 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414-4763
Practice Address - Country:US
Practice Address - Phone:561-793-0151
Practice Address - Fax:561-753-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
FLPH73743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104430300Medicaid
2005801OtherPK