Provider Demographics
NPI:1639223076
Name:WELLSCRIPTS LLC
Entity Type:Organization
Organization Name:WELLSCRIPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COLLECTION DEPARTMENT SUPER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROBERTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-272-2220
Mailing Address - Street 1:2024 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4525
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2024 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4525
Practice Address - Country:US
Practice Address - Phone:954-272-2220
Practice Address - Fax:954-272-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH200573336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1006370OtherOTHER ID NUMBER-COMMERCIAL NUMBER