Provider Demographics
NPI:1073180386
Name:M-WELL LLC
Entity Type:Organization
Organization Name:M-WELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FENG
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:734-834-1038
Mailing Address - Street 1:32393 JOHN R RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1324
Mailing Address - Country:US
Mailing Address - Phone:734-834-1038
Mailing Address - Fax:
Practice Address - Street 1:32393 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1324
Practice Address - Country:US
Practice Address - Phone:734-834-1038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy