Provider Demographics
NPI:1508149667
Name:WELLNESS CORPORATE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:WELLNESS CORPORATE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:GATHRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-229-7555
Mailing Address - Street 1:7945 MACARTHUR BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:CABIN JOHN
Mailing Address - State:MD
Mailing Address - Zip Code:20818-1634
Mailing Address - Country:US
Mailing Address - Phone:301-229-7555
Mailing Address - Fax:301-229-7054
Practice Address - Street 1:7945 MACARTHUR BLVD STE 214
Practice Address - Street 2:
Practice Address - City:CABIN JOHN
Practice Address - State:MD
Practice Address - Zip Code:20818-1634
Practice Address - Country:US
Practice Address - Phone:301-229-7555
Practice Address - Fax:301-229-7054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21D1088567291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory