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General NPI Number Information
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NPI Number | 1053423780
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Entity Type | Organization
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Legal Business Name | BE WELL PHARMACY CORP.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 8012 20TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-1809
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Country | US
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Telephone | 718-232-2320
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Fax | 718-232-2250
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Provider Business Mailing Address
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Address Line | 8012 20TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-1809
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Country | US
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Telephone | 718-232-2320
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Fax | 718-232-2250
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MARK AGRES
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Credential | R.PH, PHARM.D
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Telephone | 718-232-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 026922
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License Number State | NY
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