Organization
HEALTHWELL MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY DEWAYNE ANDRUS (PRESIDENT)
(940) 691-6100
Entity
Organization
Contact information
Practice address
783 N GROVE RD, SUITE 108, RICHARDSON, TX 75081-6209
(972) 480-0990
(972) 480-8377
Mailing address
PO BOX 4847, WICHITA FALLS, TX 76308-0847
(940) 691-6100
(940) 691-0757
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0039904
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
0039904
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011150201
—
TX
05
—
017206601
—
TX
Enumeration date
03/29/2006
Last updated
03/11/2011
Update your record
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