Healthcare Provider Details

I. General information

NPI: 1407176563
Provider Name (Legal Business Name): TOTAL WELLNESS CONCEPTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273A W SCHROCK RD
WESTERVILLE OH
43081-2874
US

IV. Provider business mailing address

273A W SCHROCK RD
WESTERVILLE OH
43081-2874
US

V. Phone/Fax

Practice location:
  • Phone: 614-414-7885
  • Fax: 614-942-6210
Mailing address:
  • Phone: 614-414-7885
  • Fax: 614-942-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPMY.022041100-03
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LAURA ATKINSON
Title or Position: CEO/OWNER
Credential: PHDABD
Phone: 614-942-6240