1124012539 NPI number — ACHIEVING BETTER CONTROL, INC

Table of content: (NPI 1124012539)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124012539 NPI number — ACHIEVING BETTER CONTROL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACHIEVING BETTER CONTROL, 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:
Provider Other Organization Name Type Code:
6
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:
1124012539
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 E HECTOR ST
Provider Second Line Business Mailing Address:
SUITE 223
Provider Business Mailing Address City Name:
CONSHOHOCKEN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19428-2374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-283-2833
Provider Business Mailing Address Fax Number:
215-283-1919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 E HECTOR ST
Provider Second Line Business Practice Location Address:
SUITE 223
Provider Business Practice Location Address City Name:
CONSHOHOCKEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19428-2374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-283-2833
Provider Business Practice Location Address Fax Number:
215-283-1919
Provider Enumeration Date:
08/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
FREEDMAN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
203-981-8950

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WD0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0001570000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3374505 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0001570000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3374512 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0001570000 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0001570000 . This is a "KEYSTONE EASTS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3374517 . This is a "AETNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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