Provider Demographics
NPI:1376001354
Name:IWO PHARMACY AND WELLNESS
Entity Type:Organization
Organization Name:IWO PHARMACY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSAFTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-304-2903
Mailing Address - Street 1:2168 TEXAS PKWY # B
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3122
Mailing Address - Country:US
Mailing Address - Phone:346-304-2903
Mailing Address - Fax:281-969-8106
Practice Address - Street 1:2168 TEXAS PKWY # B
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3122
Practice Address - Country:US
Practice Address - Phone:346-304-2903
Practice Address - Fax:281-969-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy