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General NPI Number Information
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NPI Number | 1649550963
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Entity Type | Organization
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Legal Business Name | THE WELBOURNE GROUP,LLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 6830 GARNERS FERRY RD
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City | COLUMBIA
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State | SC
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Zip | 29209-1609
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Country | US
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Telephone | 803-729-0122
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Fax | 866-771-6123
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Provider Business Mailing Address
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Address Line | 6830 GARNERS FERRY RD
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City | COLUMBIA
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State | SC
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Zip | 29209-1609
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Country | US
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Telephone | 803-729-0122
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Fax | 866-771-6123
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN W OWEN JR.
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Credential | CO, CFO, CFTS
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Telephone | 803-728-0122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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