| NPI | 1518941392 |
|---|---|
| Doing Business As | WELLNESS STORE COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ROBIN TERRERO PIC 423-476-4312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: TN 3223) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2013-04-03 |