NPIMap

Organization Active NPI

Haywood RX, LLC Dba Optimum Wellness Pharmacy

  • Compounding Pharmacy
  • Newburgh, IN
National Provider Identifier
1912373358
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
26020577 Issued in IN
Legal business name
HAYWOOD RX, LLC DBA OPTIMUM WELLNESS PHARMACY
Practice address
8900 Ruffian LN
Newburgh, IN 47630-3424
Phone
(812) 457-1204
NPI assigned
Aug 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Mr. Mark Allen Haywood, RPHNPI 1861013781
Title
Owner/Manager
Phone
(812) 457-1204

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X 26020577 IN Primary

Addresses

Primary practice location

8900 Ruffian LN
Newburgh, IN 47630-3424

Mailing address

8900 Ruffian LN
Newburgh, IN 47630-3424
Phone (812) 457-1204

National Provider Directory

National Provider Directory
Tax ID family
Haywood RX LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8900 Ruffian Ln
Newburgh, IN 47630
Phone (812) 457-1204

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1912373358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 RUFFIAN LN",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476303424",
            "telephone_number": "812-457-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 RUFFIAN LN",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476303424",
            "telephone_number": "812-457-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYWOOD RX, LLC DBA OPTIMUM WELLNESS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "HAYWOOD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "812-457-1204",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "IN",
            "license": "26020577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.