1326122276 NPI number — OXBRIDGE EDUCATORS, INC

Table of content: (NPI 1326122276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326122276 NPI number — OXBRIDGE EDUCATORS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OXBRIDGE EDUCATORS, 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:
1326122276
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5510 MUNFORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27612-2621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-870-7780
Provider Business Mailing Address Fax Number:
919-600-6700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5510 MUNFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27612-2621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-870-7780
Provider Business Practice Location Address Fax Number:
919-882-9933
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LORD
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
919-870-7780

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X , with the licence number: MHL092625 , 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: 8464 . This is a "LME PROVIDER CODE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6008071 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301492R , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6503 . This is a "LME PROGRAM CODE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8301492H , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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