Provider Demographics
NPI:1942060223
Name:VERIFI CHARLOTTE LLC
Entity Type:Organization
Organization Name:VERIFI CHARLOTTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAKA-CON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-785-8566
Mailing Address - Street 1:1909 J N PEASE PL STE 104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4561
Mailing Address - Country:US
Mailing Address - Phone:980-201-2290
Mailing Address - Fax:980-414-6014
Practice Address - Street 1:1909 J N PEASE PL STE 104
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4561
Practice Address - Country:US
Practice Address - Phone:980-201-2290
Practice Address - Fax:980-414-6014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service