Provider Demographics
NPI:1275286619
Name:COVID TESTING AND WELLNESS, LLC
Entity Type:Organization
Organization Name:COVID TESTING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NKEMAYIM
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-498-7055
Mailing Address - Street 1:7083 BRIDLE CT
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-5963
Mailing Address - Country:US
Mailing Address - Phone:443-609-4588
Mailing Address - Fax:
Practice Address - Street 1:1604 RIDGESIDE DR STE 202
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5240
Practice Address - Country:US
Practice Address - Phone:410-498-7055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center