MEDICARE: WELLMAN SLEEP SYSTEMS, 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
1	332BX2000X	Oxygen Equipment & Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1760617211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLMAN SLEEP SYSTEMS, LLC

Provider Business Mailing Address
First Line	:	123 BLUE HERON DR
Second Line	:	STE 102
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-3192
Country	:	US
Telephone Number	:	936-582-1112
Fax Number	:	936-582-1151

Provider Business Practice Location Address
First Line	:	123 BLUE HERON DR
Second Line	:	STE 102
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-3192
Country	:	US
Telephone Number	:	936-582-1112
Fax Number	:	936-582-1151

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CORTNIE RENEE WELLMAN
Credential	:	BS, RPSGT
Telephone Number	:	936-828-1919

Provider Enumeration Date	:	05/27/2009
Last Update Date	:	10/14/2009

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Directions to “WELLMAN SLEEP SYSTEMS, LLC ” Practice Location

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