Provider Demographics
NPI:1710933072
Name:WELLNESS COMPANY INC
Entity Type:Organization
Organization Name:WELLNESS COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-461-0662
Mailing Address - Street 1:132A GEORGE M COHAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4410
Mailing Address - Country:US
Mailing Address - Phone:401-461-0662
Mailing Address - Fax:401-461-3825
Practice Address - Street 1:132A GEORGE M COHAN BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4410
Practice Address - Country:US
Practice Address - Phone:401-461-0662
Practice Address - Fax:401-461-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI409982OtherBLUE CHIP OF RI
RI23999OtherBLUE CROSS/BLUE SHIELD RI
RI609023999Medicare ID - Type Unspecified