Provider Demographics
NPI:1740013366
Name:ABUNDANT WELLNESS INC
Entity type:Organization
Organization Name:ABUNDANT WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-326-6333
Mailing Address - Street 1:301 N PEPPER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1839
Mailing Address - Country:US
Mailing Address - Phone:909-326-6333
Mailing Address - Fax:909-326-6336
Practice Address - Street 1:301 N PEPPER AVE STE 300
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1839
Practice Address - Country:US
Practice Address - Phone:909-326-6333
Practice Address - Fax:909-326-6336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABUNDANT WELLNESS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy