Organization
AUSTIN WELLNESS PHARMACY, LLC
Active
Other names
Austin Wellness Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE CADDICK (OWNER)
(570) 877-2536
Entity
Organization
Contact information
Practice address
6902 AUSTIN ST STE G3, FOREST HILLS, NY 11375-4250
(718) 263-6688
(718) 263-6690
Mailing address
6902 AUSTIN ST, SUITE G3, FOREST HILLS, NY 11375-4233
(718) 263-6688
(718) 263-6690
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
032977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176863
PK
—
05
—
4050804
—
NY
Enumeration date
04/12/2018
Last updated
04/12/2018
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