Provider Demographics
NPI:1982074415
Name:ADVANCED WELLNESS SYSTEMS LLC
Entity Type:Organization
Organization Name:ADVANCED WELLNESS SYSTEMS LLC
Other - Org Name:PAIN & ARTHRITIS RELIEF CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:240-361-2225
Mailing Address - Street 1:46 W GUDE DR STE 46B
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4358
Mailing Address - Country:US
Mailing Address - Phone:240-361-2225
Mailing Address - Fax:240-361-0719
Practice Address - Street 1:46 W GUDE DR STE 46B
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1150
Practice Address - Country:US
Practice Address - Phone:240-361-2225
Practice Address - Fax:240-361-0719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-27
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01334332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies