MEDICARE: MEDICATION ENGAGEMENT REWARD INITIATIVE

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	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1437798709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICATION ENGAGEMENT REWARD INITIATIVE

Provider Business Mailing Address
First Line	:	2274 WINTHROP CHASE DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-8595
Country	:	US
Telephone Number	:	336-480-8651
Fax Number	:

Provider Business Practice Location Address
First Line	:	2274 WINTHROP CHASE DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-8595
Country	:	US
Telephone Number	:	336-480-8651
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	ANTHONY NELSON
Credential	:	MHA
Telephone Number	:	336-480-8651

Provider Enumeration Date	:	01/03/2020
Last Update Date	:	01/03/2020

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