Provider Demographics
NPI:1073405387
Name:WELLNESS EQUIPMENT SOLUTIONS LLC
Entity type:Organization
Organization Name:WELLNESS EQUIPMENT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-926-5675
Mailing Address - Street 1:2501 CHATHAM RD STE R
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4188
Mailing Address - Country:US
Mailing Address - Phone:630-592-0707
Mailing Address - Fax:
Practice Address - Street 1:2501 CHATHAM RD STE R
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-4188
Practice Address - Country:US
Practice Address - Phone:630-592-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies