Provider Demographics
NPI:1568934677
Name:WELL CENTER PHARMACY LLC
Entity Type:Organization
Organization Name:WELL CENTER PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARELLE
Authorized Official - Middle Name:REAL
Authorized Official - Last Name:ORIAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:843-615-3665
Mailing Address - Street 1:951 TOOK PL
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6505
Mailing Address - Country:US
Mailing Address - Phone:843-615-3665
Mailing Address - Fax:
Practice Address - Street 1:605 S IRBY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5211
Practice Address - Country:US
Practice Address - Phone:843-453-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy