Provider Demographics
NPI:1992514269
Name:THE WELL DISPENSARY, LLC
Entity type:Organization
Organization Name:THE WELL DISPENSARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARQUITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DODDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:336-880-3318
Mailing Address - Street 1:2855 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5168
Mailing Address - Country:US
Mailing Address - Phone:336-395-8181
Mailing Address - Fax:
Practice Address - Street 1:2855 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5168
Practice Address - Country:US
Practice Address - Phone:336-395-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy