MEDICARE: AXELSON CHIROPRACTIC HEALTH CENTER, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2478	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350046002	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0833G	OTHER	NC	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1457461980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXELSON CHIROPRACTIC HEALTH CENTER, PA

Provider Business Mailing Address
First Line	:	3334 WELLONS BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5290
Country	:	US
Telephone Number	:	252-633-3334
Fax Number	:	252-637-4483

Provider Business Practice Location Address
First Line	:	3334 WELLONS BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5290
Country	:	US
Telephone Number	:	252-633-3334
Fax Number	:	252-637-4483

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JENNIFER A BROADWAY
Credential	:
Telephone Number	:	252-633-3334

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/27/2009

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