Provider Demographics
NPI:1790343465
Name:BE WELL PHARMACY LLC
Entity Type:Organization
Organization Name:BE WELL PHARMACY LLC
Other - Org Name:BE WELL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORIUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:832-977-7887
Mailing Address - Street 1:8008 CAMP BOWIE WEST BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-6300
Mailing Address - Country:US
Mailing Address - Phone:833-310-1336
Mailing Address - Fax:888-384-2670
Practice Address - Street 1:8008 CAMP BOWIE WEST BLVD STE 109
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-6300
Practice Address - Country:US
Practice Address - Phone:682-841-0171
Practice Address - Fax:888-384-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy