Healthcare Provider Details

I. General information

NPI: 1801440409
Provider Name (Legal Business Name): HEALTH AND WELLNESS MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 ECHO RIDGE RD
CHARLOTTESVILLE VA
22911-7220
US

IV. Provider business mailing address

PO BOX 31494
HENRICO VA
23294-1494
US

V. Phone/Fax

Practice location:
  • Phone: 434-996-8582
  • Fax: 804-282-9135
Mailing address:
  • Phone: 434-996-8582
  • Fax: 804-282-9135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER L FURLOW
Title or Position: NP/OWNER
Credential: NP
Phone: 434-966-8582