| Alchemy Wellness | |
|
8639 Mayland Dr Ste 102 Henrico VA 23294-4752 | |
| (804) 993-3039 | |
| (804) 447-1953 |
| Full Name | Alchemy Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 8639 Mayland Dr Ste 102, Henrico, Virginia |
| Authorized Official Name and Position | Jon Randall Frederick (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8046902419 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alchemy Wellness 8639 Mayland Dr Ste 102 Henrico VA 23294-4752 Ph: (804) 993-3039 | Alchemy Wellness 8639 Mayland Dr Ste 102 Henrico VA 23294-4752 Ph: (804) 993-3039 |
| NPI Number | 1750923173 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 02/06/2020 |
| Certification Date | 02/06/2020 |
| Medicare PECOS PAC ID | 2961831516 |
|---|---|
| Medicare Enrollment ID | O20200401003008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750923173 | NPI | - | NPPES |
| Provider Name | Jon Randall Frederick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003997800 PECOS PAC ID: 5193944452 Enrollment ID: I20140918000700 |
| Provider Name | Paul B Brasler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356485981 PECOS PAC ID: 4789959651 Enrollment ID: I20171003003887 |
| Provider Name | Nancy R Byrne |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437676251 PECOS PAC ID: 4385902931 Enrollment ID: I20180103001370 |
| Provider Name | Priscilla Witwer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003315722 PECOS PAC ID: 1557625365 Enrollment ID: I20180502002545 |
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