Organization
WELLNESS WARE INC
Active
Organization
WELLNESS WARE INC
Active
Other names
Peggy L. Medina dba Wellness Ware
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY LEE MEDINA (OWNER)
(541) 956-7647
Entity
Organization
Contact information
Practice address
1547 NE F ST, GRANTS PASS, OR 97526-4234
(541) 956-7647
(541) 956-8739
Mailing address
1547 NE F ST, GRANTS PASS, OR 97526-4234
(541) 956-7647
(541) 956-8739
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247509
—
OR
01
—
820461000
REGENCE BCBS OREGON
OR
01
—
JE-400-01
PACIFIC SOURCE
OR
Enumeration date
01/17/2018
Last updated
01/17/2018
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