| Organization Name: | FIRSTCARE FLU & WELLNESS, LLC |
| NPI Number: | 1093175663 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILTON RICARDO SCOTT (CEO) |
| Mailing Address: | 1751 Pinnacle Dr Suite 600 Mc Lean |
| State: | VA US |
| Postal Code: | 221024903 |
| Phone Number: | 8007502019 |
| Fax Number: | 9092953142 |
| NPI Enumeration Date: | 02/25/2016 |
| NPI Last Update Date: | 02/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 0102201555 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |