MEDICARE: WONDER LIFE HOME CARE AGENCY

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1629872858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WONDER LIFE HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	301 N MAIN STREET WINSTON SALEM NC FLOOR 24
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27101
Country	:	US
Telephone Number	:	336-997-0738
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N MAIN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27101-3836
Country	:	US
Telephone Number	:	336-997-0738
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	YOLANDA SINGLETARY
Credential	:	NURSE
Telephone Number	:	336-997-0738

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/04/2025

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