Wellmart RX, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

WELLMART RX, INC.

Practice address

21913 Jamaica Ave
Queens Village, NY 11428-2126

Phone

(718) 704-0808

Fax

(718) 704-0818

NPI assigned

Sep 25, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Simon Davydov

Title

President

Phone

(718) 704-0808

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1023488681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21913 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282126",
            "telephone_number": "718-704-0808",
            "fax_number": "718-704-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21913 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282126",
            "telephone_number": "718-704-0808",
            "fax_number": "718-704-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMART RX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-704-0808"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Stewart Washburn, D.C.
• Gail Weinberg, M.A., C.C.C.-S.L.P.
• Gary Weinberg, RPH
• Cassandra Weingarten, ATR-BC, LCAT
• Doreen E Weinstein, LCSW-R
• Karen L Werbin Eckert, LCSW
• Bibi K Wethington-Roger, LPN
• White Glove
• Monica White-Williams, RN
• Vanessa Williams

• Pharmacy in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.