Provider Demographics
NPI:1922422757
Name:YORK WELLNESS PHARMACY LLC
Entity Type:Organization
Organization Name:YORK WELLNESS PHARMACY LLC
Other - Org Name:YORK WELLNESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHAITANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHITTIMALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-747-3586
Mailing Address - Street 1:605 S GEORGE ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-3160
Mailing Address - Country:US
Mailing Address - Phone:717-747-3586
Mailing Address - Fax:717-747-3642
Practice Address - Street 1:605 S GEORGE ST STE 130
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3161
Practice Address - Country:US
Practice Address - Phone:717-747-3586
Practice Address - Fax:717-747-3642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4824473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2144271OtherPK