Provider Demographics
NPI:1750112546
Name:WELLNESS WHEELS LLC
Entity type:Organization
Organization Name:WELLNESS WHEELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:KABACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-417-2529
Mailing Address - Street 1:5 GREAT PASTURE RD UNIT 9
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-3148
Mailing Address - Country:US
Mailing Address - Phone:203-417-2529
Mailing Address - Fax:
Practice Address - Street 1:5 GREAT PASTURE RD UNIT 9
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-3148
Practice Address - Country:US
Practice Address - Phone:203-417-2529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)