1992370407 NPI number — ABLE, LLC

Table of content: (NPI 1992370407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992370407 NPI number — ABLE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABLE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992370407
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O BOX 464
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT DEPOSIT
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36032-4508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-227-4115
Provider Business Mailing Address Fax Number:
334-227-4115

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
554 GOLSON RD EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT DEPOSIT
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36032-4508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-227-4115
Provider Business Practice Location Address Fax Number:
334-227-4115
Provider Enumeration Date:
05/26/2021

Additional Information

Authorized Official

Authorized Official Last Name:
BARBER
Authorized Official First Name:
HERBERT
Authorized Official Middle Name:
LAMAR
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
334-617-6453

Provider Taxonomy Codes

  • Taxonomy code: 343800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3619666 . This is a "US DOT #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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