1417157348 NPI number — ELAINE A BEED M D INC

Table of content: (NPI 1417157348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417157348 NPI number — ELAINE A BEED M D INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELAINE A BEED M D INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELAINE A. BEED M.D
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417157348
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 641185
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45264-0302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-523-1611
Provider Business Mailing Address Fax Number:
614-794-4289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 COOPER RD STE 600
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43081-9235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-523-1611
Provider Business Practice Location Address Fax Number:
614-794-4289
Provider Enumeration Date:
07/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BEED
Authorized Official First Name:
ELAINE
Authorized Official Middle Name:
ALFREDA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
614-523-1611

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  045906 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0600666 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 830007614 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".