Organization Active NPI

Your Wellness Pharmacy Corp

  • Pharmacy
  • Jamaica, NY
National Provider Identifier
1780194415
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
YOUR WELLNESS PHARMACY CORP
Practice address
12614 Merrick Blvd Ste F
Jamaica, NY 11434-3431
Phone
(718) 880-0000
NPI assigned
Oct 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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

Authorized official

Name
Abismael Quiles Serrano
Title
President
Phone
(718) 880-0000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

12614 Merrick Blvd Ste F
Jamaica, NY 11434-3431

Mailing address

12614 Merrick Blvd Ste F
Jamaica, NY 11434-3431

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1780194415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12614 MERRICK BLVD STE F",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12614 MERRICK BLVD STE F",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343431",
            "telephone_number": "718-880-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR WELLNESS PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "QUILES SERRANO",
        "authorized_official_first_name": "ABISMAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-880-0000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.