Provider Demographics
NPI:1760509178
Name:EWELLNESS, LLC
Entity Type:Organization
Organization Name:EWELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-704-3305
Mailing Address - Street 1:7750 ZIONSVILLE RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5126
Mailing Address - Country:US
Mailing Address - Phone:317-704-3305
Mailing Address - Fax:317-704-3314
Practice Address - Street 1:7750 ZIONSVILLE RD
Practice Address - Street 2:SUITE 800
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5126
Practice Address - Country:US
Practice Address - Phone:317-704-3305
Practice Address - Fax:317-704-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN69000261A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000275195OtherANTHEM PROVIDER ID NUMBER
IN000000275195OtherANTHEM PROVIDER ID NUMBER