MEDICARE: COVID TESTING 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	:	1275286619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COVID TESTING AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	7083 BRIDLE CT
Second Line	:
City	:	SYKESVILLE
State	:	MD
Zip	:	21784-5963
Country	:	US
Telephone Number	:	443-609-4588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1604 RIDGESIDE DR STE 202
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5240
Country	:	US
Telephone Number	:	410-498-7055
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	EMILIENNE NKEMAYIM
Credential	:	CRNP
Telephone Number	:	410-498-7055

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	01/26/2022

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Directions to “COVID TESTING AND WELLNESS, LLC ” Practice Location

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