Provider Demographics
NPI:1467927731
Name:WELLNESS MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:WELLNESS MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HUASCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-464-0144
Mailing Address - Street 1:10491 N KENDALL DR STE E105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1597
Mailing Address - Country:US
Mailing Address - Phone:786-464-0144
Mailing Address - Fax:305-849-5961
Practice Address - Street 1:10491 N KENDALL DR # E105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1597
Practice Address - Country:US
Practice Address - Phone:786-464-0144
Practice Address - Fax:305-849-5961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies