| NPI | 1134798556 |
|---|---|
| Doing Business As | LIFE WELL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PHILIP BLAKE MUSICK Shareholder 276-591-7035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-06-21 |