NPIMap

Organization Active NPI

Wellcare Pharmacy 4 LLC

Doing business as Wellcare Pharmacy 4

  • Community/Retail Pharmacy
  • Philadelphia, PA
National Provider Identifier
1376033365
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PP482786 Issued in PA
Legal business name
WELLCARE PHARMACY 4 LLC
Doing business as
Wellcare Pharmacy 4
Practice address
600 Washington Ave
Unit 12
Philadelphia, PA 19147-4836
Phone
(267) 488-1099
Fax
(267) 488-1098
NPI assigned
May 15, 2018
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Zengxing LiNPI 1518607811
Title
President
Phone
(267) 488-1099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PP482786 PA Primary

Addresses

Primary practice location

600 Washington Ave
Unit 12
Philadelphia, PA 19147-4836

Mailing address

600 Washington Ave
Unit 12
Philadelphia, PA 19147-4836
Phone (267) 488-1099

Other identifiers 1

IdentifierTypeStateIssuer
2177796OtherPK

Other names 1

  • Wellcare Pharmacy 4 Doing business as

National Provider Directory

National Provider Directory

Locations

600 Washington Ave
Unit 12
Philadelphia, PA 19147
Phone (267) 488-1099

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1376033365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WASHINGTON AVE",
            "address_2": "UNIT 12",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474836",
            "telephone_number": "267-488-1099",
            "fax_number": "267-488-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WASHINGTON AVE",
            "address_2": "UNIT 12",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474836",
            "telephone_number": "267-488-1099",
            "fax_number": "267-488-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE PHARMACY 4 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "ZENGXING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-488-1099"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177796",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellcare Pharmacy 4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.