Provider Demographics
NPI:1104009422
Name:WUM SALES LLC
Entity Type:Organization
Organization Name:WUM SALES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ULRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-747-7900
Mailing Address - Street 1:114 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5798
Mailing Address - Country:US
Mailing Address - Phone:516-747-7900
Mailing Address - Fax:516-747-4840
Practice Address - Street 1:114 7TH ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5798
Practice Address - Country:US
Practice Address - Phone:516-747-7900
Practice Address - Fax:516-747-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7379940001Medicare NSC