# HOMELAND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760704308
- **Authorized official:** MS. SHARON MARIE GRAY (MANAGING MEMBER/CEO)
- **Authorized official phone:** (813) 433-1669

## Contact information

- **Practice address:** 6601 MEMORIAL HWY, SUITE 219, TAMPA, FL 33615-4501
- **Practice address phone:** (813) 433-1669
- **Practice address fax:** (813) 433-1724
- **Mailing address:** 6601 MEMORIAL HWY, SUITE 219, TAMPA, FL 33615-4501
- **Mailing address phone:** (813) 433-1669
- **Mailing address fax:** (813) 433-1724

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1800X | Corporate Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/24/2010
- **Last updated:** 03/23/2010