MEDICARE: E 2 C GROUP, LLC

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	171W00000X	Contractor	2705098416A	VA

General Provider Information

NPI Number	:	1851562078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E 2 C GROUP, LLC

Provider Business Mailing Address
First Line	:	1206 WARREN AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-3740
Country	:	US
Telephone Number	:	804-553-9995
Fax Number	:	804-553-9993

Provider Business Practice Location Address
First Line	:	1206 WARREN AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-3740
Country	:	US
Telephone Number	:	804-553-9995
Fax Number	:	804-553-9993

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	MS. DENISE I FIELDS
Credential	:
Telephone Number	:	804-553-9995

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	03/14/2008

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