Wellcare Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054020144 Issued in IL

Legal business name

WELLCARE PHARMACY LLC

Practice address

9760 S Kedzie Ave
Evergreen Park, IL 60805-3109

Phone

(708) 930-5927

Fax

(708) 930-5935

NPI assigned

Dec 22, 2016

Last updated

Mar 23, 2017By 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

Hani Abdallah, RPHNPI 1851488787

Title

Owner, Ao, Phcy Manager, Pic

Phone

(708) 307-7839

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Hani F Abdallah, PHARMACIST

  • Pharmacist
  • Homer Glen, IL
  • NPI 1851488787
  Authorized official Same address or phone

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1760927057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-930-5927",
            "fax_number": "708-930-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053109",
            "telephone_number": "708-930-5927",
            "fax_number": "708-930-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-22",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "ABDALLAH",
        "authorized_official_first_name": "HANI",
        "authorized_official_title_or_position": "OWNER,  AO, PHCY MANAGER, PIC",
        "authorized_official_telephone_number": "708-307-7839",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054020144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deon Shere Watkins, NP
• Hussam Watti, MD
• Amy Wazio
• Weil Foot and Ankle Institute LLC
• Christine Ann Weingarten, PHD
• Wellcare Physician Services, Inc.
• Taylor Wen, PA-C
• Tanya Jeannine West-Hutchins, NP
• Joseph P Whalen, DVM
• Steven Hirsch Whitman, P.T.

• Community/Retail Pharmacy in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.