Wellness Store Compounding Pharmacy
LBN: Robin Godfrey Terrero
Wellness Store Compounding Pharmacy is an health care organization with primary practice located at 3555 Keith St Nw Ste 210 , Cleveland TN 37312-4375. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Robin Godfrey Terrero can be contacted via phone (423) 476-4312, or through Terrero, Robin via phone (423) 476-4312.
Contact Information
Primary practice address
3555 Keith St Nw Ste 210
Cleveland TN 37312-4375
Phone: (423) 476-4312
Fax: (423) 476-7982
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | 3223 | Tennessee |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | ||
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1518941392 |
|---|---|
| LBN Legal business name | Robin Godfrey Terrero |
| DBA Doing business as | Wellness Store Compounding Pharmacy |
| Authorized official | Terrero, Robin RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Apr 3rd, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518941392 | NPPES |
| Other | 2092295 | PK | |
| MEDICAID | 1452909 | PK |
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