1306441282 NPI number — WELLNESS MEDICAL EQUIPMENT AND SUPPLIES

Table of content: (NPI 1306441282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306441282 NPI number — WELLNESS MEDICAL EQUIPMENT AND SUPPLIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELLNESS MEDICAL EQUIPMENT AND SUPPLIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306441282
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
454 ANDERSON RD S # BTC583
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCK HILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29730-3392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-470-3585
Provider Business Mailing Address Fax Number:
855-448-9509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
454 ANDERSON RD S
Provider Second Line Business Practice Location Address:
SUITE #132
Provider Business Practice Location Address City Name:
ROCK HILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-373-2840
Provider Business Practice Location Address Fax Number:
855-448-9509
Provider Enumeration Date:
12/01/2020

Additional Information

Authorized Official

Authorized Official Last Name:
CHANDLER
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER / EMPLOYEE
Authorized Official Telephone Number:
803-470-3585

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com