=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124012539
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACHIEVING BETTER CONTROL, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2005
-----------------------------------------------------
Last Update Date | 03/30/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1100 E HECTOR ST SUITE 223
-----------------------------------------------------
City | CONSHOHOCKEN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19428-2374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-283-2833
-----------------------------------------------------
Fax | 215-283-1919
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1100 E HECTOR ST SUITE 223
-----------------------------------------------------
City | CONSHOHOCKEN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19428-2374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-283-2833
-----------------------------------------------------
Fax | 215-283-1919
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. MICHAEL B FREEDMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 203-981-8950
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WD0400X
-----------------------------------------------------
Taxonomy Name | Diabetes Educator Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------