Provider Demographics
NPI:1922610112
Name:EVERWELL SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:EVERWELL SPECIALTY PHARMACY, LLC
Other - Org Name:EVERWELL SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:850-473-9190
Mailing Address - Street 1:6506 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6957
Mailing Address - Country:US
Mailing Address - Phone:850-473-9190
Mailing Address - Fax:
Practice Address - Street 1:6506 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6957
Practice Address - Country:US
Practice Address - Phone:850-473-9190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REVELATION PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-19
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy