Provider Demographics
NPI:1518190941
Name:WELL-DONE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:WELL-DONE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WELDON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:904-472-5374
Mailing Address - Street 1:36 S COLLEGE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2439
Mailing Address - Country:US
Mailing Address - Phone:904-472-5374
Mailing Address - Fax:904-259-0579
Practice Address - Street 1:36 S COLLEGE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2439
Practice Address - Country:US
Practice Address - Phone:904-472-5374
Practice Address - Fax:904-259-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6328160001Medicare NSC