WLJ Enterprizes, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WLJ ENTERPRIZES, LLC

Doing business as

Southern Horizons Medical Equip.

Practice address

100 Gantt LN
Fayetteville, GA 30215-2176

Phone

(678) 643-0201

Fax

(678) 962-5855

NPI assigned

Sep 20, 2006

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

Vice-President

Phone

(678) 643-0201

Specialties & licenses 1

Addresses

Other names 1

• Southern Horizons Medical Equip. 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 Enterprises LLC

  dba Southern Horizon Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • Fayetteville, GA
  • NPI 1336417849
  NPD tax ID

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558469320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANTT LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152176",
            "telephone_number": "678-643-0201",
            "fax_number": "678-962-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GANTT LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152176",
            "telephone_number": "678-643-0201",
            "fax_number": "678-962-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WLJ ENTERPRIZES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAZZILLO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "678-643-0201",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Horizons Medical Equip.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Latoya Leigh Wise, CRNA
• Terrence Wise, MD
• Erin Davis Wisehart, LMFT
• Michael Brian Witherspoon, PA
• WLJ Enterprises LLC (Southern Horizon Medical Equipment)
• Jessyca Alexis Wofford, DMD
• 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 Aug 22, 2020; 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.