Healthcare Provider Details

I. General information

NPI: 1912527979
Provider Name (Legal Business Name): WELLNESS 1 PHARMACY - MASON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 10/23/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6681 WESTERN ROW RD
MASON OH
45040-1305
US

IV. Provider business mailing address

6681 WESTERN ROW RD
MASON OH
45040-1305
US

V. Phone/Fax

Practice location:
  • Phone: 513-548-0022
  • Fax: 513-548-0023
Mailing address:
  • Phone: 513-548-0022
  • Fax: 513-548-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. AYMAN FATHI YAHYA
Title or Position: PRESIDENT/OWNER
Credential: PHARMD
Phone: 513-515-9366