All Well Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH25397 Issued in FL

Legal business name

ALL WELL PHARMACY INC

Practice address

5452 Blanding Blvd
Jacksonville, FL 32244-1957

Phone

(904) 779-6990

Fax

(904) 779-6995

NPI assigned

Apr 18, 2011

Organization subpart

No

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

Authorized official

Name

Sumanth Kumar EdaraNPI 1093007775

Title

President

Phone

(904) 779-6990

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• All Well Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Sumanth Kumar Edara, RPH

  • Pharmacist
  • Jacksonville, FL
  • NPI 1093007775
  NPD Authorized official
• Ravi Boppana

  • Pharmacist
  • Jacksonville, FL
  • NPI 1336536747
  NPD (past)

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1609166198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5452 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322441957",
            "telephone_number": "904-779-6990",
            "fax_number": "904-779-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5452 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322441957",
            "telephone_number": "904-779-6990",
            "fax_number": "904-779-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL WELL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "EDARA",
        "authorized_official_first_name": "SUMANTH",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-779-6990"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH25397",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003613300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2129850",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "All Well Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "All Well Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jacksonville, FL
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.