Provider Demographics
NPI:1033516505
Name:CNU MEDICAL INSTITUTE
Entity Type:Organization
Organization Name:CNU MEDICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:EMELIA
Authorized Official - Middle Name:ADA
Authorized Official - Last Name:ORUBELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-964-9596
Mailing Address - Street 1:10935 DONAMERE DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5610
Mailing Address - Country:US
Mailing Address - Phone:404-964-9596
Mailing Address - Fax:
Practice Address - Street 1:5855 JIMMY CARTER BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2929
Practice Address - Country:US
Practice Address - Phone:678-879-0721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017342333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy