Provider Demographics
NPI:1245785740
Name:FAMILY CARE & WELLNESS LLC
Entity Type:Organization
Organization Name:FAMILY CARE & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MARKWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-591-8233
Mailing Address - Street 1:19101 E VALLEY VIEW PKWY
Mailing Address - Street 2:SUITE D
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6904
Mailing Address - Country:US
Mailing Address - Phone:816-591-8233
Mailing Address - Fax:816-257-1200
Practice Address - Street 1:19101 E VALLEY VIEW PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6904
Practice Address - Country:US
Practice Address - Phone:816-591-8233
Practice Address - Fax:816-257-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4D97261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1134120223OtherNPI
MO1134120223OtherNPI