Organization
CHARICEM VENTURES PLLC
Active
Other names
TRENTON MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AYODELE ADELEKE OLUSANYA M.D. (PRESIDENT)
(731) 855-3719
Entity
Organization
Contact information
Practice address
120 DAVY CROCKETT MALL, TRENTON, TN 38382-2934
(731) 855-3719
(731) 855-1746
Mailing address
120 DAVY CROCKETT MALL, TRENTON, TN 38382-2934
(731) 855-3719
(731) 855-1746
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3735738
—
TN
01
—
DF6302
RAILROAD MEDICARE
TN
Enumeration date
03/02/2007
Last updated
07/21/2022
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