Provider Demographics
NPI:1073405361
Name:COREWELL LLC
Entity type:Organization
Organization Name:COREWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:412-610-3107
Mailing Address - Street 1:445 SAINT CLAIR AVE
Mailing Address - Street 2:PO BOX 102
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-9998
Mailing Address - Country:US
Mailing Address - Phone:412-610-3107
Mailing Address - Fax:
Practice Address - Street 1:409 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-2006
Practice Address - Country:US
Practice Address - Phone:412-610-3107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-19
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care