Provider Demographics
NPI:1497585228
Name:VET WELL RX
Entity type:Organization
Organization Name:VET WELL RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:HAIVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:IMMLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-223-1044
Mailing Address - Street 1:2150 W NORTHWEST HWY STE 118
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-6993
Mailing Address - Country:US
Mailing Address - Phone:682-223-1044
Mailing Address - Fax:682-223-1412
Practice Address - Street 1:2150 W NORTHWEST HWY STE 118
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6993
Practice Address - Country:US
Practice Address - Phone:682-223-1044
Practice Address - Fax:682-223-1412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835C0207XPharmacy Service ProvidersPharmacistCompounded Sterile PreparationsGroup - Multi-Specialty
No333600000XSuppliersPharmacyGroup - Multi-Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy