Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers | |
Prosthetic/Orthotic Supplier |
335E00000X | 51 | Medical Supply Company with Orthotist |
| NPI Number | 1861413205 |
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| LBN Legal business name | ANCILLARY SERVICES MANAGEMENT, LLC | ||||||||||||||||||||||||||||||||||||
| Authorized official | DANIEL KIGHT - (PRESIDENT) | ||||||||||||||||||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||||||||||||||||||
| Enumeration date | 07/21/2006 | ||||||||||||||||||||||||||||||||||||
| Last updated | 08/30/2011 - About 15 years ago | ||||||||||||||||||||||||||||||||||||
| Identifiers |
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