Provider Demographics
NPI:1619760899
Name:HERVOLVE WELLNESS LLC
Entity type:Organization
Organization Name:HERVOLVE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATIMILEHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:UGBADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-404-2245
Mailing Address - Street 1:7651 MATAPEAKE BUSINESS DR STE 212
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-3038
Mailing Address - Country:US
Mailing Address - Phone:301-404-2245
Mailing Address - Fax:
Practice Address - Street 1:7651 MATAPEAKE BUSINESS DR STE 212
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-3038
Practice Address - Country:US
Practice Address - Phone:301-404-2245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care