TRINA DIABETES OF CHARLOTTE, PLLC - NPI NUMBER 1811337835

Summary

Provider Name: TRINA DIABETES OF CHARLOTTE, PLLC

NPI Number: 1811337835

Clasification: Clinic/Center (261QI0500X)

Specialization: Infusion Therapy

Address:
300 BILLINGSLEY RD
SUITE 108
CHARLOTTE, NC
ZIP 28211

Phone Number: (855) 698-7462



Detailed Information

TRINA DIABETES OF CHARLOTTE, PLLC is an infusion therapy clinic/center in Charlotte, NC. The assigned NPI number for this provider is 1811337835 and is registered as an organization entity type.

The provider's business address is:

300 BILLINGSLEY RD
SUITE 108
CHARLOTTE, NC
ZIP 28211-075
Phone: (855) 698-7462

The provider's authorized official is Chiedu Okocha .
The authorized official title is Member and has the following contact phone number (336) 509-2463.

The enumeration date for this NPI number is 7/5/2013 and was last updated on 7/5/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QI0500X Clinic/Center Infusion Therapy 200401289 NC Yes

NPI Record

No. Field Name Field Value
1 NPI 1811337835
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name TRINA DIABETES OF CHARLOTTE, PLLC
5 Provider First Line Business Practice Location Address 300 BILLINGSLEY RD
6 Provider Second Line Business Practice Location Address SUITE 108
7 Provider Business Practice Location Address City Name CHARLOTTE
8 Provider Business Practice Location Address State Name NC
9 Provider Business Practice Location Address Postal Code 282111075
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 8556987462
12 Provider Enumeration Date 7/5/2013
13 Last Update Date 7/5/2013
14 Authorized Official Last Name OKOCHA
15 Authorized Official First Name CHIEDU
16 Authorized Official Title or Position MEMBER
17 Authorized Official Telephone Number 3365092463
18 Healthcare Provider Taxonomy Code 1 261QI0500X
19 Provider License Number 1 200401289
20 Provider License Number State Code 1 NC
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Organization Subpart N
23 Authorized Official Name Prefix Text DR.
24 Authorized Official Credential Text M.D.

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.