Provider Demographics
NPI:1225511843
Name:WETRIUM,LLC
Entity Type:Organization
Organization Name:WETRIUM,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-298-0592
Mailing Address - Street 1:1101 OHIO DR STE 115
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5331
Mailing Address - Country:US
Mailing Address - Phone:469-298-0592
Mailing Address - Fax:469-298-3404
Practice Address - Street 1:1101 OHIO DR STE 115
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5331
Practice Address - Country:US
Practice Address - Phone:469-298-0592
Practice Address - Fax:469-298-3404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy