1750683900 NPI number — ABOVE AND BEYOND EXPECTATION, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750683900 NPI number — ABOVE AND BEYOND EXPECTATION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABOVE AND BEYOND EXPECTATION, 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:
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:
1750683900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2905 AUTUMN SUNSET CT
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:
27616-7228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-673-2146
Provider Business Mailing Address Fax Number:
252-442-0013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3905 IVERSON ST
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:
27604-4975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-673-2146
Provider Business Practice Location Address Fax Number:
252-442-0013
Provider Enumeration Date:
11/20/2010

Additional Information

Authorized Official

Authorized Official Last Name:
WESTERN
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
BYRD
Authorized Official Title or Position:
ADMINISTRATOR, VICE PRESIDENT
Authorized Official Telephone Number:
919-673-2146

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X , with the licence number:  FCL-092-165 , 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)





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