Provider Demographics
NPI:1326651555
Name:PURFORMANCE WELLNESS PHARMACY LLC
Entity Type:Organization
Organization Name:PURFORMANCE WELLNESS PHARMACY LLC
Other - Org Name:SEVEN CELLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-467-5333
Mailing Address - Street 1:600 SE INDIAN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5540
Mailing Address - Country:US
Mailing Address - Phone:561-467-5333
Mailing Address - Fax:561-467-4899
Practice Address - Street 1:600 SE INDIAN ST STE 3
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5540
Practice Address - Country:US
Practice Address - Phone:561-467-5333
Practice Address - Fax:561-467-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-27
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy