Provider Demographics
NPI:1568865897
Name:WELLNESS RX LLC
Entity Type:Organization
Organization Name:WELLNESS RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND MANAGING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:ULLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MPA
Authorized Official - Phone:518-589-9500
Mailing Address - Street 1:40 MILLER ROAD, PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:MOUNT TREMPER
Mailing Address - State:NY
Mailing Address - Zip Code:12457
Mailing Address - Country:US
Mailing Address - Phone:845-687-8500
Mailing Address - Fax:845-687-8501
Practice Address - Street 1:5980 MAIN ST
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12485-7719
Practice Address - Country:US
Practice Address - Phone:845-443-3192
Practice Address - Fax:845-687-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy