MEDICARE: PERFECT PEACE HEALTH AND WELLNESS 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1194690198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFECT PEACE HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	2602 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1301
Country	:	US
Telephone Number	:	267-619-7778
Fax Number	:

Provider Business Practice Location Address
First Line	:	2602 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1301
Country	:	US
Telephone Number	:	267-619-7778
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARY THORNTON-BOWMER
Credential	:	DNP, CRNP
Telephone Number	:	267-619-7778

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	04/17/2026

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