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General NPI Number Information
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NPI Number | 1528109485
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Entity Type | Organization
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Legal Business Name | CCI BILLING SERVICES LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 1500 LEE BLVD
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-4835
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Country | US
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Telephone | 239-368-4517
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Fax |
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Provider Business Mailing Address
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Address Line | 92 E MCNAB RD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-9238
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Country | US
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Telephone | 954-545-0337
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Fax | 954-545-3497
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES TRENTHAM
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Credential | MD
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Telephone | 954-545-0337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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