Provider Demographics
NPI:1831863364
Name:TA POWE CORPORATION
Entity type:Organization
Organization Name:TA POWE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANIKA
Authorized Official - Middle Name:K
Authorized Official - Last Name:POWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-657-4664
Mailing Address - Street 1:10118 FOREST LANDING DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4058
Mailing Address - Country:US
Mailing Address - Phone:704-657-4664
Mailing Address - Fax:
Practice Address - Street 1:10118 FOREST LANDING DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4058
Practice Address - Country:US
Practice Address - Phone:704-657-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management