Provider Demographics
NPI:1225023922
Name:HOME WELLNESS, LLC
Entity type:Organization
Organization Name:HOME WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:RAWLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-895-7815
Mailing Address - Street 1:1055 WESTGATE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1451
Mailing Address - Country:US
Mailing Address - Phone:888-280-8632
Mailing Address - Fax:
Practice Address - Street 1:700 ROUTE 130 N
Practice Address - Street 2:SUITE 208
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3365
Practice Address - Country:US
Practice Address - Phone:856-864-1549
Practice Address - Fax:800-563-2937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1220523922Medicaid
MD509902100Medicaid
DC88808800Medicaid
PA0015241300005Medicaid
VA10074118Medicaid
NJ6487602Medicaid
PA0015241300005Medicaid