NPIMap

Organization Active NPI

Wedgewood Pharmacy LLC

Doing business as Wickliffe Veterinary Pharmacy

  • Mail Order Pharmacy
  • Lexington, KY
National Provider Identifier
1023779212
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
Legal business name
WEDGEWOOD PHARMACY LLC
Doing business as
Wickliffe Veterinary Pharmacy
Practice address
4340 Georgetown Road
Lexington, KY 40511-9115
Phone
(859) 389-7470
Fax
(856) 491-4365
NPI assigned
Jan 10, 2022
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alejandro Bernal-Angel
Title
Chief Executive Officer, Secretary
Phone
(973) 307-7154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X Primary

Addresses

Primary practice location

4340 Georgetown Road
Lexington, KY 40511-9115

Mailing address

405 Heron Drive
Suite 200
Swedesboro, NJ 08085
Phone (800) 331-8272

Other names 2

  • Wickliffe Veterinary Pharmacy Doing business as
  • Wickliffe LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Wedgewood Pharmacy LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4340 Georgetown Rd
Lexington, KY 40511
Phone (859) 389-7470

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1023779212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 HERON DRIVE",
            "address_2": "SUITE 200",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "08085",
            "telephone_number": "800-331-8272",
            "fax_number": "856-491-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 GEORGETOWN ROAD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405119115",
            "telephone_number": "859-389-7470",
            "fax_number": "856-491-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDGEWOOD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-05-27",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "BERNAL-ANGEL",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER, SECRETARY",
        "authorized_official_telephone_number": "973-307-7154"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wickliffe Veterinary Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wickliffe LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.