Provider Demographics
NPI:1033903893
Name:YOUR WELLNESS RX PHARMACY INC
Entity type:Organization
Organization Name:YOUR WELLNESS RX PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEWAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-545-2121
Mailing Address - Street 1:2107 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3247
Mailing Address - Country:US
Mailing Address - Phone:718-545-2121
Mailing Address - Fax:718-545-2124
Practice Address - Street 1:2107 21ST AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3247
Practice Address - Country:US
Practice Address - Phone:718-545-2121
Practice Address - Fax:718-545-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy