Provider Demographics
NPI:1841038387
Name:WELLNESS PHARMACY INC.
Entity type:Organization
Organization Name:WELLNESS PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIZADEH-MIAB
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:480-999-9100
Mailing Address - Street 1:16810 E EL PUEBLO BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2533
Mailing Address - Country:US
Mailing Address - Phone:480-999-9100
Mailing Address - Fax:480-999-9200
Practice Address - Street 1:16810 E EL PUEBLO BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-2533
Practice Address - Country:US
Practice Address - Phone:480-999-9100
Practice Address - Fax:480-999-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy