WLJ Enterprises LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WLJ ENTERPRISES LLC

Practice address

230 Industrial Way Ste B
Fayetteville, GA 30215-8262

Phone

(678) 643-0201

NPI assigned

Dec 12, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Vincent Gerard Mazzillo

Title

Operations Manager

Phone

(678) 643-0201

Specialties & licenses 1

Addresses

Other names 1

• Southern Horizon Medical Equipment Doing business as

Tax ID family

Southern Horizon Medical Equipment2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• WLJ Enterprizes, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fayetteville, GA
  • NPI 1558469320
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1336417849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 INDUSTRIAL WAY STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302158262",
            "telephone_number": "678-643-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 INDUSTRIAL WAY STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302158262",
            "telephone_number": "678-643-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WLJ ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "MAZZILLO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "678-643-0201",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Horizon Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gina D Wise
• Latoya Leigh Wise, CRNA
• Terrence Wise, MD
• Erin Davis Wisehart, LMFT
• Michael Brian Witherspoon, PA
• WLJ Enterprizes, LLC
• Laura Wolf, OT
• Deirdre Dannette Womack
• Women'S Community Care, PC
• Kelly Natasha Wood, MD

• Durable Medical Equipment & Medical Supplies in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.