MEDICARE: TRUENTITY CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336M0003X	Managed Care Organization Pharmacy

General Provider Information

NPI Number	:	1073252334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUENTITY CORPORATION

Provider Business Mailing Address
First Line	:	10030 GREEN LEVEL CHURCH RD STE 802188
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-8194
Country	:	US
Telephone Number	:	617-877-8872
Fax Number	:

Provider Business Practice Location Address
First Line	:	10030 GREEN LEVEL CHURCH RD STE 802188
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-8194
Country	:	US
Telephone Number	:	617-877-8872
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. MIKE DESAI
Credential	:
Telephone Number	:	617-877-8872

Provider Enumeration Date	:	06/03/2022
Last Update Date	:	06/03/2022

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Directions to “TRUENTITY CORPORATION ” Practice Location

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