Provider Demographics
NPI:1912216490
Name:WEIGHT AND WELLNESS INC
Entity Type:Organization
Organization Name:WEIGHT AND WELLNESS INC
Other - Org Name:UNIVERSITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMON
Authorized Official - Suffix:
Authorized Official - Credentials:BSC
Authorized Official - Phone:954-530-5794
Mailing Address - Street 1:1868 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4129
Mailing Address - Country:US
Mailing Address - Phone:954-530-5794
Mailing Address - Fax:866-761-6574
Practice Address - Street 1:1868 N UNIVERSITY DR STE 105
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4110
Practice Address - Country:US
Practice Address - Phone:954-530-5794
Practice Address - Fax:866-761-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH248463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5701986OtherNCPDP PROVIDER IDENTIFICATION NUMBER