Provider Demographics
NPI:1790221588
Name:AV WELLNESS INC
Entity Type:Organization
Organization Name:AV WELLNESS INC
Other - Org Name:DOWNTOWN WELLNESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVROM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-599-1781
Mailing Address - Street 1:135 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5208
Mailing Address - Country:US
Mailing Address - Phone:347-599-1781
Mailing Address - Fax:347-987-3176
Practice Address - Street 1:135 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5208
Practice Address - Country:US
Practice Address - Phone:347-599-1781
Practice Address - Fax:347-987-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy