| NPI | 1477755601 |
|---|---|
| Doing Business As | WELLSPRING CUSTOM PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JAMES BRADLEY ROSEBOROUGH President 419-756-2559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: OH 021068200) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |