Healthcare Provider Details

I. General information

NPI: 1811811706
Provider Name (Legal Business Name): MEDWELL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16551 W WAREN AVE
DETROIT MI
48228
US

IV. Provider business mailing address

16551 W WARREN AVE
DETROIT MI
48228-3706
US

V. Phone/Fax

Practice location:
  • Phone: 313-283-6902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ADAM QAYED
Title or Position: OWNER
Credential:
Phone: 313-283-6902