Wellness Compounding Pharmacy

LBN: Wellness Compounding Pharmacy
Wellness Compounding Pharmacy is an health care organization with primary practice located at 522 Crater Lake Ave , Medford OR 97504-6810. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty. Wellness Compounding Pharmacy can be contacted via phone (541) 774-3939, or through Meeker, Angie via phone (541) 301-1465.

Contact Information

Primary practice address
522 Crater Lake Ave Medford OR 97504-6810
Phone: (541) 774-3939
Fax: (541) 774-3933
Website:
Map and Directions
Authorized official contact:
Name: Meeker, Angie PHARMD
Phone: (541) 301-1465

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X RP002452C0S Oregon

Profile Details

NPI number 1063682805
LBN Legal business name Wellness Compounding Pharmacy
DBA Doing business as Wellness Compounding Pharmacy
Authorized official Meeker, Angie PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2008
Last updated Jul 19th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063682805 NPPES
Oregon MEDICAID 500738873
Oregon Other 2079579

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