WELLLIFE:A DIABETES CLINIC AND EDUCATIONAL RESOURCE CENTER NPI 1255526224

NPI Information

NPI: 1255526224
Provider Name: WELLLIFE:A DIABETES CLINIC AND EDUCATIONAL RESOURCE CENTER
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
331 TRYON RD STE 103A
RALEIGH, NC
ZIP 27603
Phone: (919) 624-6533
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WELLLIFE:A DIABETES CLINIC AND EDUCATIONAL RESOURCE CENTER is a health service clinic center in Raleigh, NC. WELLLIFE:A DIABETES CLINIC AND EDUCATIONAL RESOURCE CENTER NPI is 1255526224. The provider is registered as an organization entity type.

The provider's business location address is:

331 TRYON RD STE 103A
RALEIGH, NC
ZIP 27603-583
Phone: (919) 624-6533

The provider's authorized official is Dwan Thompson Kelsey .
The authorized official title is Ceo and has the following contact phone number (919) 624-6533.

The enumeration date for this NPI number is 9/12/2007 and was last updated on 1/30/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	261QH0100X	Clinic/Center	Health Service	900229	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q26755	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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