Provider Demographics
NPI:1427672096
Name:WELLNESS MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:WELLNESS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEWALE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-302-7788
Mailing Address - Street 1:6518 HIGHWAY 85 STE G
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2364
Mailing Address - Country:US
Mailing Address - Phone:404-302-7788
Mailing Address - Fax:
Practice Address - Street 1:6518 HIGHWAY 85 STE G
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2364
Practice Address - Country:US
Practice Address - Phone:404-302-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies