Healthcare Provider Details
I. General information
NPI: 1780300236
Provider Name (Legal Business Name): 2WELL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2022
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2216 HIGHWAY 80 E LOT 162
MONROE LA
71203-9475
US
IV. Provider business mailing address
2216 HIGHWAY 80 E LOT 162
MONROE LA
71203-9475
US
V. Phone/Fax
- Phone: 318-307-5729
- Fax:
- Phone: 318-307-5729
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANTONIO
O
BURNS
Title or Position: OWNER/MANAGER
Credential:
Phone: 318-307-5729