Organization
MEDWELL RX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO CARLOS LEE (OWNER)
(718) 676-4966
Entity
Organization
Contact information
Practice address
2205 86TH ST, BROOKLYN, NY 11214-4107
(718) 676-4966
(718) 676-4967
Mailing address
2205 86TH ST, BROOKLYN, NY 11214-4107
(718) 676-4966
(718) 676-4967
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038689
PHARMACY LICENSE
NY
05
—
06608286
—
NY
Enumeration date
04/06/2021
Last updated
01/10/2024
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