Provider Demographics
NPI:1215458344
Name:B WELLNESS SERVICES LLC
Entity type:Organization
Organization Name:B WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MBA, APRN-RX
Authorized Official - Phone:808-214-7236
Mailing Address - Street 1:2838 E MANOA RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1822
Mailing Address - Country:US
Mailing Address - Phone:808-214-7236
Mailing Address - Fax:
Practice Address - Street 1:1019 UNIVERSITY AVE STE 6A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1509
Practice Address - Country:US
Practice Address - Phone:808-214-7236
Practice Address - Fax:808-427-3589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2202261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service