Provider Demographics
NPI:1962275636
Name:SOMI CARE LLC
Entity type:Organization
Organization Name:SOMI CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIDINMA
Authorized Official - Middle Name:
Authorized Official - Last Name:EZENNAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-226-8360
Mailing Address - Street 1:3500 STONEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3232
Mailing Address - Country:US
Mailing Address - Phone:980-226-8360
Mailing Address - Fax:
Practice Address - Street 1:3500 STONEHAVEN DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3232
Practice Address - Country:US
Practice Address - Phone:980-226-8360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty