MEDICARE: GET WELL PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	023483	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770695314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GET WELL PHARMACY INC.

Provider Business Mailing Address
First Line	:	5218 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2816
Country	:	US
Telephone Number	:	718-686-0812
Fax Number	:	718-686-0811

Provider Business Practice Location Address
First Line	:	5218 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2816
Country	:	US
Telephone Number	:	718-686-0812
Fax Number	:	718-686-0811

Authorized Official
Title or Position	:	V. PRESIDENT
Name	:	PHILIP PENG
Credential	:
Telephone Number	:	718-686-0812

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/25/2022

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