Provider Demographics
NPI:1710332242
Name:WELLNESS PHARMACY OF CARY LLC
Entity Type:Organization
Organization Name:WELLNESS PHARMACY OF CARY LLC
Other - Org Name:WELLNESS PHARMACY OF CARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PASOOKHUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-694-5357
Mailing Address - Street 1:3750 NW CARY PKWY STE 112
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8432
Mailing Address - Country:US
Mailing Address - Phone:919-694-5357
Mailing Address - Fax:919-694-5404
Practice Address - Street 1:3750 NW CARY PKWY STE 112
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8432
Practice Address - Country:US
Practice Address - Phone:919-694-5357
Practice Address - Fax:919-694-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2162347OtherPK