Provider Demographics
NPI:1326385782
Name:ABC INVESTMENTS, LLC
Entity Type:Organization
Organization Name:ABC INVESTMENTS, LLC
Other - Org Name:INCONTINENCE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BART
Authorized Official - Middle Name:O
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:208-360-3663
Mailing Address - Street 1:3539 BRIAR CREEK LN
Mailing Address - Street 2:STE B
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-4761
Mailing Address - Country:US
Mailing Address - Phone:208-360-3663
Mailing Address - Fax:208-552-7847
Practice Address - Street 1:3539 BRIAR CREEK LN
Practice Address - Street 2:STE B
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-4761
Practice Address - Country:US
Practice Address - Phone:208-360-3663
Practice Address - Fax:208-552-7847
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABC INVESTMENTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDW21488332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies