Provider Demographics
NPI:1033656798
Name:AMERICAN MEDICAL LLC
Entity Type:Organization
Organization Name:AMERICAN MEDICAL LLC
Other - Org Name:WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:VERSACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-821-2777
Mailing Address - Street 1:9 E LOOCKERMAN ST
Mailing Address - Street 2:202
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-8306
Mailing Address - Country:US
Mailing Address - Phone:954-821-2777
Mailing Address - Fax:954-933-5835
Practice Address - Street 1:9 E. LOCKERMAN STREET
Practice Address - Street 2:#202
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901
Practice Address - Country:US
Practice Address - Phone:954-821-2777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies