1306972856 NPI number — BLUEWEST OPPORTUNITIES, INC.

Table of content: (NPI 1306972856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306972856 NPI number — BLUEWEST OPPORTUNITIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLUEWEST OPPORTUNITIES, 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:
1306972856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28802-1250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-274-8368
Provider Business Mailing Address Fax Number:
828-274-1424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
91 POPLAR CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWANNANOA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28778-2458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-686-7385
Provider Business Practice Location Address Fax Number:
828-686-0330
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STUART
Authorized Official First Name:
MIRIAM
Authorized Official Middle Name:
NADINE
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
828-274-8368

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X , with the licence number:  MHL-011-007 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3406434 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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