Wellpharm LLC

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHRE008814 Issued in GA

Legal business name

WELLPHARM LLC

Practice address

2260 Holly Springs Pkwy
Suite 180
Canton, GA 30115-9580

Phone

(770) 704-6161

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Dale M Coker, RPH

Title

Manager Pharmacist in Charge

Phone

(770) 704-6161

Specialties & licenses 1

Addresses

Other names 1

• Cherokee Custom Script Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Coker, PHARM.D.

  • Pharmacist
  • Norcross, GA
  • NPI 1285918565
  NPD
• Burgandy Ann Payne

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Chatsworth, GA
  • NPI 1912519745
  NPD (past)
• Austin Tull, PHARMD

  • Pharmacist
  • Canton, GA
  • NPI 1598256364
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104960202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 HOLLY SPRINGS PKWY",
            "address_2": "SUITE 180",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159580",
            "telephone_number": "770-704-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 HOLLY SPRINGS PKWY",
            "address_2": "SUITE 180",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159580",
            "telephone_number": "770-704-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLPHARM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COKER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "770-704-6161",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "PHRE008814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherokee Custom Script Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Weinman, MD
• Lisa Gordon Weiss, PA-C
• Shannon Weist, LCSW
• Jordan H Weitzner, M.D.
• Wellness Chiropractic Center
• Wellstar Cardiovascular Medicine, LLC
• Wellstar Medical Group, LLC
• Wellstar Medical Group, LLC
• Wellstreet of Georgia PC
• Julie Marie Wenger

• Pharmacist in Canton, GA
• Providers in Canton, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.