# MEDIWELL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538142542
- **Authorized official:** MR. RANDY FREEMAN (PRESIDENT)
- **Authorized official phone:** (817) 735-4210

## Contact information

- **Practice address:** 5354 WEST VICKERY, FORT WORTH, TX 76107
- **Practice address phone:** (817) 735-4210
- **Practice address fax:** (817) 735-4390
- **Mailing address:** 5354 WEST VICKERY, FORT WORTH, TX 76107
- **Mailing address phone:** (817) 735-4210
- **Mailing address fax:** (817) 735-4390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0036298 | TX | Yes |

## Other

- **Enumeration date:** 11/23/2005
- **Last updated:** 08/22/2020