Provider Demographics
NPI:1487361168
Name:WELLNESS ENTERPRISES LLC
Entity type:Organization
Organization Name:WELLNESS ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:OTU
Authorized Official - Last Name:ONWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-939-6070
Mailing Address - Street 1:2620 S PARKER RD STE 160
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1676
Mailing Address - Country:US
Mailing Address - Phone:720-939-6070
Mailing Address - Fax:719-358-7465
Practice Address - Street 1:2224 E PIKES PEAK AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5906
Practice Address - Country:US
Practice Address - Phone:719-428-2003
Practice Address - Fax:719-358-7465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO14374906OtherSECRETARY OF STATE