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Organization
ACHIEVE BEYOND
Active
Organization
ACHIEVE BEYOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELINDA TEAGUE (NJ REGIONAL DIRECTOR)
(646) 554-7205
Entity
Organization
Contact information
Practice address
581 MAIN ST STE 640, WOODBRIDGE, NJ 07095-1196
(718) 762-7633
Mailing address
89 BERNICE RD, BELLEVILLE, NJ 07109-1562
(973) 508-6117
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SKR834438479
BLUECROSS BLUESHIELD
IL
Enumeration date
10/19/2015
Last updated
10/19/2015
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