Provider Demographics
NPI:1972866135
Name:WELL FUTURE PHARMACY LLC
Entity Type:Organization
Organization Name:WELL FUTURE PHARMACY LLC
Other - Org Name:CAPSULE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:KINARIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-685-9515
Mailing Address - Street 1:122 W 146TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3802
Mailing Address - Country:US
Mailing Address - Phone:888-685-9515
Mailing Address - Fax:646-934-6409
Practice Address - Street 1:661 N WELLS ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3616
Practice Address - Country:US
Practice Address - Phone:312-589-7620
Practice Address - Fax:312-589-7621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDY CITY ACQUISITION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-21
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540179433336C0003X, 3336C0003X
333600000X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135734OtherPK