MEDICARE: GARDEN OF EDEN HEALTH CENTER PC

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548732936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDEN OF EDEN HEALTH CENTER PC

Provider Business Mailing Address
First Line	:	9460 AMBERDALE DR STE A
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-1259
Country	:	US
Telephone Number	:	804-362-7372
Fax Number	:	866-834-5648

Provider Business Practice Location Address
First Line	:	9460 AMBERDALE DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-1259
Country	:	US
Telephone Number	:	804-362-7372
Fax Number	:	866-834-5648

Authorized Official
Title or Position	:	MD
Name	:	DR. ASENA L MADISON
Credential	:	MD
Telephone Number	:	804-381-8769

Provider Enumeration Date	:	12/22/2018
Last Update Date	:	01/31/2025

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Directions to “GARDEN OF EDEN HEALTH CENTER PC ” Practice Location

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