Austin Wellness Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032977 Issued in NY

Legal business name

AUSTIN WELLNESS PHARMACY, LLC

Doing business as

Austin Wellness Pharmacy

Practice address

6902 Austin St Ste G3
Forest Hills, NY 11375-4250

Phone

(718) 263-6688

Fax

(718) 263-6690

NPI assigned

Apr 12, 2018

Organization subpart

No

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

Authorized official

Name

Steve Caddick

Title

Owner

Phone

(570) 877-2536

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Austin Wellness Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523491200000",
    "number": "1376040683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6902 AUSTIN ST",
            "address_2": "SUITE G3",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754233",
            "telephone_number": "718-263-6688",
            "fax_number": "718-263-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6902 AUSTIN ST STE G3",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754250",
            "telephone_number": "718-263-6688",
            "fax_number": "718-263-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN WELLNESS PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A",
        "authorized_official_last_name": "CADDICK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-877-2536"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176863",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4050804",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Wellness Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.