Provider Demographics
NPI:1306377346
Name:CAREWELL INC
Entity Type:Organization
Organization Name:CAREWELL INC
Other - Org Name:ELITE & SURGICAL DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ILYAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-880-1940
Mailing Address - Street 1:11114 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1812
Mailing Address - Country:US
Mailing Address - Phone:718-880-1940
Mailing Address - Fax:
Practice Address - Street 1:11114 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1812
Practice Address - Country:US
Practice Address - Phone:718-880-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032781302R00000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No302R00000XManaged Care OrganizationsHealth Maintenance Organization