Provider Demographics
NPI:1457033904
Name:MEDIWELL PHARMACY LLC
Entity Type:Organization
Organization Name:MEDIWELL PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:781-572-4930
Mailing Address - Street 1:32 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1206
Mailing Address - Country:US
Mailing Address - Phone:781-572-4930
Mailing Address - Fax:
Practice Address - Street 1:1008 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3118
Practice Address - Country:US
Practice Address - Phone:609-341-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy