Healthcare Provider Details

I. General information

NPI: 1366309213
Provider Name (Legal Business Name): WELLNESSJET MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8115 MAPLE LAWN BLVD STE 350
FULTON MD
20759-2683
US

IV. Provider business mailing address

8115 MAPLE LAWN BLVD STE 350
FULTON MD
20759-2683
US

V. Phone/Fax

Practice location:
  • Phone: 240-281-0736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BEATRICE ATANGA
Title or Position: MANAGING MEMBER
Credential:
Phone: 240-281-0736