Organization
YOUR WELLNESS PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABISMAEL QUILES SERRANO (PRESIDENT)
(718) 880-0000
Entity
Organization
Contact information
Practice address
12614 MERRICK BLVD STE F, JAMAICA, NY 11434-3431
(718) 880-0000
Mailing address
12614 MERRICK BLVD STE F, JAMAICA, NY 11434-3431
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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