Healthcare Provider Details

I. General information

NPI: 1033052113
Provider Name (Legal Business Name): EXQU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ASHLEY PARK LN APT 311
CHARLOTTE NC
28210-4149
US

IV. Provider business mailing address

4845 ASHLEY PARK LN APT 311
CHARLOTTE NC
28210-4149
US

V. Phone/Fax

Practice location:
  • Phone: 512-996-7374
  • Fax:
Mailing address:
  • Phone: 512-996-7374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY UZO CHIBIFE
Title or Position: GENERAL PARTNER
Credential:
Phone: 512-996-7374