Provider Demographics
NPI:1275418378
Name:HEALWELL DME LLC
Entity type:Organization
Organization Name:HEALWELL DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VENKATA LAKSHMI SIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDUMUDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-302-0310
Mailing Address - Street 1:61 W PALISADE AVE # 2B
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2706
Mailing Address - Country:US
Mailing Address - Phone:551-302-0310
Mailing Address - Fax:
Practice Address - Street 1:61 W PALISADE AVE # 2B
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2706
Practice Address - Country:US
Practice Address - Phone:551-302-0310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies