Provider Demographics
NPI:1942921283
Name:MMH WELLNESS CORP
Entity Type:Organization
Organization Name:MMH WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-440-9308
Mailing Address - Street 1:1456 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11102-4564
Mailing Address - Country:US
Mailing Address - Phone:718-440-9308
Mailing Address - Fax:718-440-9309
Practice Address - Street 1:1456 30TH AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11102-4564
Practice Address - Country:US
Practice Address - Phone:718-440-9308
Practice Address - Fax:718-440-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy