Provider Demographics
NPI:1396824884
Name:XEON ENTERPRISES INC
Entity type:Organization
Organization Name:XEON ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-658-0500
Mailing Address - Street 1:100 W. POLLOCK STREET
Mailing Address - Street 2:STE 2
Mailing Address - City:MT. OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-2000
Mailing Address - Country:US
Mailing Address - Phone:919-658-0500
Mailing Address - Fax:919-658-5599
Practice Address - Street 1:100 W POLLOCK ST
Practice Address - Street 2:STE 2
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-2000
Practice Address - Country:US
Practice Address - Phone:919-658-0500
Practice Address - Fax:919-658-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2545251J00000X
NCHC-2545251F00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408027Medicaid
NC6601087Medicaid
NC6800467Medicaid