1871341149 NPI number — BEAUTY EMBRACE MEDSPA, PLLC

Table of content: PHILBERT ARNOLD MONACELLI RPH (NPI 1174600134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871341149 NPI number — BEAUTY EMBRACE MEDSPA, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEAUTY EMBRACE MEDSPA, PLLC
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:
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Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871341149
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1220 TIMBER DR E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARNER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27529-6917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
984-960-9654
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8801 FAST PARK DRIVE SUITE 301
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:
27617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
984-960-9654
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/10/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
JANIETA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/NP
Authorized Official Telephone Number:
630-930-2975

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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