Organization
WLJ ENTERPRISES LLC
Active
Other names
Southern Horizon Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT GERARD MAZZILLO (OPERATIONS MANAGER)
(678) 643-0201
Entity
Organization
Contact information
Practice address
230 INDUSTRIAL WAY STE B, FAYETTEVILLE, GA 30215-8262
(678) 643-0201
Mailing address
230 INDUSTRIAL WAY STE B, FAYETTEVILLE, GA 30215-8262
(678) 643-0201
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/12/2011
Last updated
11/27/2013
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