Organization
WELLD68 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINE PATTY HANNAH (SURROGATE)
(770) 892-0687
Entity
Organization
Contact information
Practice address
1003 SHADY LN NW, KENNESAW, GA 30152-3431
(770) 693-7921
Mailing address
PO BOX 1536, KENNESAW, GA 30156-8536
(770) 892-0687
(770) 892-0688
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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