# YOUR WELLNESS PHARMACY CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780194415
- **Authorized official:** ABISMAEL QUILES SERRANO (PRESIDENT)
- **Authorized official phone:** (718) 880-0000

## Contact information

- **Practice address:** 12614 MERRICK BLVD STE F, JAMAICA, NY 11434-3431
- **Practice address phone:** (718) 880-0000
- **Mailing address:** 12614 MERRICK BLVD STE F, JAMAICA, NY 11434-3431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/09/2017
- **Last updated:** 10/09/2017