Provider Demographics
NPI:1114729944
Name:LIFEWELL RX PHARMACY LTC
Entity type:Organization
Organization Name:LIFEWELL RX PHARMACY LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:GYAMFI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:502-742-5958
Mailing Address - Street 1:2200 BUECHEL AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2664
Mailing Address - Country:US
Mailing Address - Phone:502-742-5958
Mailing Address - Fax:502-742-5490
Practice Address - Street 1:2200 BUECHEL AVE STE 104
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2664
Practice Address - Country:US
Practice Address - Phone:502-742-5958
Practice Address - Fax:502-742-5490
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFEWELL RX PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-25
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy