Provider Demographics
NPI:1083937122
Name:ADB MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:ADB MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BAMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-347-2752
Mailing Address - Street 1:121 HARRISON AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-2307
Mailing Address - Country:US
Mailing Address - Phone:310-347-2752
Mailing Address - Fax:513-202-1370
Practice Address - Street 1:121 HARRISON AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2307
Practice Address - Country:US
Practice Address - Phone:310-347-2752
Practice Address - Fax:513-202-1370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2882411332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2882411Medicaid
OH1508015330OtherNPI (OLD)