Provider Demographics
NPI:1538992045
Name:WELLNESS MEDICAL SVCS PC
Entity type:Organization
Organization Name:WELLNESS MEDICAL SVCS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-771-7277
Mailing Address - Street 1:1427 HORSHAM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1320
Mailing Address - Country:US
Mailing Address - Phone:215-326-9065
Mailing Address - Fax:215-703-9776
Practice Address - Street 1:1427 HORSHAM RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1320
Practice Address - Country:US
Practice Address - Phone:215-771-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty