Provider Demographics
NPI:1245878867
Name:WELLS PHARMACY
Entity type:Organization
Organization Name:WELLS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:KURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-932-3040
Mailing Address - Street 1:247 N LITCHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-1227
Mailing Address - Country:US
Mailing Address - Phone:623-932-3040
Mailing Address - Fax:623-932-3961
Practice Address - Street 1:247 N LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-1227
Practice Address - Country:US
Practice Address - Phone:623-932-3040
Practice Address - Fax:623-932-3961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLS PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-13
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy