Provider Demographics
NPI:1205936440
Name:WELLNESS HEALTH SYSTEMS, INC.
Entity type:Organization
Organization Name:WELLNESS HEALTH SYSTEMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:AZIZ
Authorized Official - Last Name:GIRGIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-890-3500
Mailing Address - Street 1:383 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1447
Mailing Address - Country:US
Mailing Address - Phone:614-890-3500
Mailing Address - Fax:614-890-7353
Practice Address - Street 1:383 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1447
Practice Address - Country:US
Practice Address - Phone:614-890-3500
Practice Address - Fax:614-890-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2243261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9342101Medicare ID - Type UnspecifiedCLINIC PROVIDER NUMBER