Wellcare Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28493 Issued in TX

Legal business name

WELLCARE PHARMACY LLC

Doing business as

Wellcare pharmacy

Practice address

4200 South Fwy Ste 26
Fort Worth, TX 76115-1400

Phone

(817) 263-5050

Fax

(817) 263-5020

NPI assigned

Apr 1, 2013

Last updated

Oct 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Varghese Nellikunnat Varkey

Title

Owner

Phone

(817) 263-5050

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wellcare pharmacy Doing business as

Locations

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.

• Nannie Blanche Johnson

  • Pharmacist
  • Fort Worth, TX
  • NPI 1467160002
  NPD

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1417290008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 26",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151400",
            "telephone_number": "817-263-5050",
            "fax_number": "817-263-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SOUTH FWY STE 26",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761151400",
            "telephone_number": "817-263-5050",
            "fax_number": "817-263-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "VARKEY",
        "authorized_official_first_name": "VARGHESE NELLIKUNNAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-263-5050"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139768",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146771",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellcare pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellcare pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sarah Ryan Wellborn, LCSW
• Wellcare Transport LLC
• Wellington Emergency Specialists, LLC
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• Audra Wellington, LVN, BSC, CLC
• Isatu J Wellington, FNP-C

• Community/Retail Pharmacy in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.