Healthcare Provider Details

I. General information

NPI: 1164081816
Provider Name (Legal Business Name): WENTZEL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 S HIGHWAY 14 STE 1B
GREENVILLE SC
29615-7110
US

IV. Provider business mailing address

105 MEADOW BLOSSOM WAY
SIMPSONVILLE SC
29681-6588
US

V. Phone/Fax

Practice location:
  • Phone: 864-757-4951
  • Fax: 864-606-6240
Mailing address:
  • Phone: 864-497-2655
  • Fax: 864-606-6240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: MEREDITH WENTZEL
Title or Position: OWNER
Credential: IBCLC
Phone: 864-757-4951