Provider Demographics
NPI:1427422302
Name:THE CHARIOT GROUP LLC
Entity type:Organization
Organization Name:THE CHARIOT GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:NDOYO
Authorized Official - Last Name:MWALALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-361-4919
Mailing Address - Street 1:3723 PHILLIPS WAY E
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1734
Mailing Address - Country:US
Mailing Address - Phone:919-361-4919
Mailing Address - Fax:919-361-4919
Practice Address - Street 1:3723 PHILLIPS WAY E
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1734
Practice Address - Country:US
Practice Address - Phone:919-361-4919
Practice Address - Fax:919-361-4919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHARIOT GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4696251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health