NPIMap

Organization Active NPI

Wolf Medical Inc.

  • Customized Equipment (DME)
  • Rome, GA
National Provider Identifier
1669776126
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
20115654383 Issued in GA
Legal business name
WOLF MEDICAL INC.
Practice address
1715 Martha Berry Blvd NW
Rome, GA 30165-1623
Phone
(706) 233-8200
Fax
(706) 233-8277
NPI assigned
Dec 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Mr. Gary Harold Quellet
Title
President
Phone
(706) 233-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 20115654383 GA Primary

Addresses

Primary practice location

1715 Martha Berry Blvd NW
Rome, GA 30165-1623

Mailing address

1715 Martha Berry Blvd NW
Rome, GA 30165-1623
Phone (706) 233-8200

National Provider Directory

National Provider Directory

Locations

1715 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 233-8200

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1669776126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651623",
            "telephone_number": "706-233-8200",
            "fax_number": "706-233-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651623",
            "telephone_number": "706-233-8200",
            "fax_number": "706-233-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "QUELLET",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-233-8200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "20115654383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.