Provider Demographics
NPI:1457232209
Name:PUREWELL PHARMACY LLC
Entity type:Organization
Organization Name:PUREWELL PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSANEME
Authorized Official - Middle Name:
Authorized Official - Last Name:OKARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-273-1344
Mailing Address - Street 1:8730 N MOBLEY RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2509
Mailing Address - Country:US
Mailing Address - Phone:813-553-5010
Mailing Address - Fax:813-756-2151
Practice Address - Street 1:8730 N MOBLEY RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-2509
Practice Address - Country:US
Practice Address - Phone:813-553-5010
Practice Address - Fax:813-756-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy