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NPI Code Detail

MEDICARE: WELLNESS EMPIRE

MEDICARE: WELLNESS EMPIRE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1912513037
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLNESS EMPIRE
Provider Business Mailing Address
First Line : 805 E WILSON AVE UNIT B
Second Line :
City : GLENDALE
State : CA
Zip : 91206-4457
Country : US
Telephone Number : 818-396-5678
Fax Number :
Provider Business Practice Location Address
First Line : 805 E WILSON AVE UNIT B
Second Line :
City : GLENDALE
State : CA
Zip : 91206-4457
Country : US
Telephone Number : 818-396-5678
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ARTUR GHUKASYAN
Credential :
Telephone Number : 213-210-6279
Provider Enumeration Date : 09/23/2020
Last Update Date : 10/15/2020

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Directions to “WELLNESS EMPIRE ” Practice Location

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