Provider Demographics
NPI:1831806249
Name:WELLNESS PLUS LLC
Entity type:Organization
Organization Name:WELLNESS PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSEGUN
Authorized Official - Middle Name:BOLA
Authorized Official - Last Name:ADEYEMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-399-1150
Mailing Address - Street 1:1076 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2467
Mailing Address - Country:US
Mailing Address - Phone:973-399-1150
Mailing Address - Fax:
Practice Address - Street 1:1076 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2467
Practice Address - Country:US
Practice Address - Phone:973-399-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLNESSPLUS PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy