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General NPI Number Information
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NPI Number | 1033815691
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Entity Type | Organization
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Legal Business Name | 88 HEALTHY PHARMACY LLC
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 14320 45TH AVE
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City | FLUSHING
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State | NY
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Zip | 11355-2231
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Country | US
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Telephone | 718-799-0819
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Fax | 718-799-0987
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Provider Business Mailing Address
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Address Line | 14320 45TH AVE
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City | FLUSHING
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State | NY
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Zip | 11355-2231
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Country | US
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Telephone | 718-799-0819
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Fax | 718-799-0987
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | WANLIN CHANG
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Credential |
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Telephone | 718-799-0819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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