Provider Demographics
NPI:1154628220
Name:WELLNESS WORLD ALLIANCE 'CODE SAVE OUR MEDICARE'
Entity Type:Organization
Organization Name:WELLNESS WORLD ALLIANCE 'CODE SAVE OUR MEDICARE'
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RVT/TECHNICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHENEKIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-685-7232
Mailing Address - Street 1:708 RUE MARSEILLE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-6671
Mailing Address - Country:US
Mailing Address - Phone:757-232-2400
Mailing Address - Fax:
Practice Address - Street 1:5749 AMBERBROOKE ARCH APT 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-9122
Practice Address - Country:US
Practice Address - Phone:757-232-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA127157261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service