Provider Demographics
NPI:1891303616
Name:AMWELL PHARMACY INC.
Entity Type:Organization
Organization Name:AMWELL PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ACHILLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ALON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:732-673-1244
Mailing Address - Street 1:438 ROUTE 206 STE 3
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5525
Mailing Address - Country:US
Mailing Address - Phone:908-829-3431
Mailing Address - Fax:908-829-4316
Practice Address - Street 1:438 ROUTE 206 STE 3
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5525
Practice Address - Country:US
Practice Address - Phone:908-829-3431
Practice Address - Fax:908-829-4316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00778600OtherNJ BOARD OF PHARMACY