Provider Demographics
NPI:1437661592
Name:CNU MEDICAL LLC
Entity Type:Organization
Organization Name:CNU MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMELIA
Authorized Official - Middle Name:ADA
Authorized Official - Last Name:ORUBELE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, CPHT
Authorized Official - Phone:678-879-0721
Mailing Address - Street 1:5855 JIMMY CARTER BLVD STE 190
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-4610
Mailing Address - Country:US
Mailing Address - Phone:678-879-0721
Mailing Address - Fax:678-893-0942
Practice Address - Street 1:5855 JIMMY CARTER BLVD STE 190
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4610
Practice Address - Country:US
Practice Address - Phone:678-879-0721
Practice Address - Fax:678-893-0942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory