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NPI Code Detail

MEDICARE: MAX-WELLNESS, LLC

MEDICARE: MAX-WELLNESS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1386912087
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAX-WELLNESS, LLC
Provider Business Mailing Address
First Line : 4400 RENAISSANCE PKWY
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-5794
Country : US
Telephone Number : 216-765-2500
Fax Number :
Provider Business Practice Location Address
First Line : 4044 MORSE CROSSING
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6037
Country : US
Telephone Number : 614-414-0955
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : ROSS POLLOCK
Credential :
Telephone Number : 216-765-2500
Provider Enumeration Date : 12/08/2011
Last Update Date : 12/08/2011

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