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General NPI Number Information
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NPI Number | 1538950779
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Entity Type | Organization
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Legal Business Name | FLAVORFUEL, LLC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/17/2025
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Provider Practice Location Address
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Address Line | 4050 MEREDITH WOODS LN
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City | WINSTON SALEM
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State | NC
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Zip | 27107-6975
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Country | US
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Telephone | 336-705-4415
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 MEREDITH WOODS LN
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City | WINSTON SALEM
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State | NC
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Zip | 27107-6975
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | MARCHENE THOMAS
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Credential |
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Telephone | 336-705-4415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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