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General NPI Number Information
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NPI Number | 1316347248
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Entity Type | Organization
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Legal Business Name | AUSTIN WELLNESS PHARMACY LLC.
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 6902 AUSTIN ST
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City | FOREST HILLS
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State | NY
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Zip | 11375-4233
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Country | US
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Telephone | 718-263-6688
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Fax | 718-263-6690
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Provider Business Mailing Address
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Address Line | 6902 AUSTIN ST
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City | FOREST HILLS
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State | NY
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Zip | 11375-4233
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Country | US
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Telephone | 718-263-6688
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Fax | 718-263-6690
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Authorized Official
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Title or Position | MEMBER
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Name | MAN YEE CHIN
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Credential |
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Telephone | 718-263-6688
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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 | 032977
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License Number State | NY
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