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General NPI Number Information
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NPI Number | 1790343465
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Entity Type | Organization
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Legal Business Name | BE WELL PHARMACY LLC
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 8008 CAMP BOWIE WEST BLVD STE 109
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City | FORT WORTH
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State | TX
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Zip | 76116-6300
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Country | US
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Telephone | 682-841-0171
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Fax | 888-384-2670
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Provider Business Mailing Address
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Address Line | 8008 CAMP BOWIE WEST BLVD STE 109
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City | FORT WORTH
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State | TX
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Zip | 76116-6300
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Country | US
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Telephone | 833-310-1336
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Fax | 888-384-2670
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Authorized Official
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Title or Position | OFFICER
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Name | MR. GREGORIUS M BROWN JR.
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Credential |
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Telephone | 832-977-7887
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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 |
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License Number State |
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