Organization
CHARICEM VENTURES PLLC
Active
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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