Provider Demographics
NPI:1881705051
Name:ODIN CORP.
Entity type:Organization
Organization Name:ODIN CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:EDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-696-0533
Mailing Address - Street 1:1532 HAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-2338
Mailing Address - Country:US
Mailing Address - Phone:828-696-0533
Mailing Address - Fax:828-696-1487
Practice Address - Street 1:1532 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-2338
Practice Address - Country:US
Practice Address - Phone:828-696-0533
Practice Address - Fax:828-696-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1487341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406804Medicaid
NC0723XOtherBC/BS OF NORTH CAROLINA
NC590009386OtherRAILROAD MEDICARE
NC0723XOtherBC/BS OF NORTH CAROLINA