Provider Demographics
NPI:1871465211
Name:WELL CARE COMMUNITY HEALTH RX, LLC
Entity type:Organization
Organization Name:WELL CARE COMMUNITY HEALTH RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-973-9294
Mailing Address - Street 1:203 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-4208
Mailing Address - Country:US
Mailing Address - Phone:765-914-5115
Mailing Address - Fax:765-973-9233
Practice Address - Street 1:25 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:IN
Practice Address - Zip Code:47102-1303
Practice Address - Country:US
Practice Address - Phone:765-914-5115
Practice Address - Fax:765-973-9233
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELL CARE COMMUNITY HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy