MEDICARE: ESSENCE OF LIFE WELLNESS CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1336186238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENCE OF LIFE WELLNESS CENTER, INC.

Provider Business Mailing Address
First Line	:	2801 MCRAE RD
Second Line	:	SUITE 2C
City	:	RICHMOND
State	:	VA
Zip	:	23235-3056
Country	:	US
Telephone Number	:	804-320-5454
Fax Number	:	804-327-9025

Provider Business Practice Location Address
First Line	:	2801 MCRAE RD
Second Line	:	SUITE 2C
City	:	RICHMOND
State	:	VA
Zip	:	23235-3056
Country	:	US
Telephone Number	:	804-320-5454
Fax Number	:	804-327-9025

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YOLANDA SAPINI
Credential	:
Telephone Number	:	804-320-5454

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	08/22/2020

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