Provider Demographics
NPI:1528549557
Name:WELLFORT CORPORATION
Entity Type:Organization
Organization Name:WELLFORT CORPORATION
Other - Org Name:ACUSCRIPT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NGUYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:469-909-4093
Mailing Address - Street 1:3950 S CARRIER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-6671
Mailing Address - Country:US
Mailing Address - Phone:469-909-4093
Mailing Address - Fax:469-909-4094
Practice Address - Street 1:3950 S CARRIER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-6671
Practice Address - Country:US
Practice Address - Phone:469-909-4093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy