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Organization
WENSLEY ORTHO LABS, INC
Active
Organization
WENSLEY ORTHO LABS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA M WENSLEY PMAC (CO OWNER)
(336) 659-3595
Entity
Organization
Contact information
Practice address
1531 WESTBROOK PLAZA DR STE K, WINSTON SALEM, NC 27103
(336) 659-3595
(336) 659-3596
Mailing address
1531 WESTBROOK PLAZA DR STE K, WINSTON SALEM, NC 27103-1330
(336) 659-3595
(336) 659-3596
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0448W
BCBS PROVIDER NUMBER
NC
01
—
36607
PARTNERS PROVIDER NUMBER
NC
05
—
7703050
—
NC
05
—
7795205
—
NC
01
—
B3022
MEDCOST PROVIDER NUMBER
NC
Enumeration date
06/16/2005
Last updated
08/16/2018
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