Healthcare Provider Details

I. General information

NPI: 1114856408
Provider Name (Legal Business Name): EVERWELL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22835 VAN DYKE AVE
WARREN MI
48089-2356
US

IV. Provider business mailing address

22835 VAN DYKE AVE
WARREN MI
48089-2356
US

V. Phone/Fax

Practice location:
  • Phone: 313-589-0404
  • Fax:
Mailing address:
  • Phone: 313-589-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: TAHMINA BEGUM
Title or Position: OWNER/MEMBER
Credential:
Phone: 313-589-0404