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Organization
MEDIWELL INC
Active
Organization
MEDIWELL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY FREEMAN (PRESIDENT)
(817) 735-4210
Entity
Organization
Contact information
Practice address
5354 WEST VICKERY, FORT WORTH, TX 76107
(817) 735-4210
(817) 735-4390
Mailing address
5354 WEST VICKERY, FORT WORTH, TX 76107
(817) 735-4210
(817) 735-4390
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0036298
TX
Other
Enumeration date
11/23/2005
Last updated
08/22/2020
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