Organization
CCI BILLING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES TRENTHAM MD (OWNER)
(954) 545-0337
Entity
Organization
Contact information
Practice address
1500 LEE BLVD, LEHIGH ACRES, FL 33936-4835
(239) 368-4517
Mailing address
92 E MCNAB RD, POMPANO BEACH, FL 33060-9238
(954) 545-0337
(954) 545-3497
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278080100
—
FL
01
—
612438900
WORKMANS COMP
FL
01
—
99300
BLUE CROSS
FL
01
—
DG2104
RAILROAD MEDICARE
FL
Enumeration date
02/12/2007
Last updated
08/26/2008
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