Provider Demographics
NPI:1972914950
Name:WELLS, DENISE (RPH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S WHEELING ST
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3962
Mailing Address - Country:US
Mailing Address - Phone:419-697-2010
Mailing Address - Fax:419-697-2065
Practice Address - Street 1:1725 S WHEELING ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3962
Practice Address - Country:US
Practice Address - Phone:419-697-2010
Practice Address - Fax:419-697-2065
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031223311835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy