Provider Demographics
NPI:1437381936
Name:AJB ASSOCIATES
Entity Type:Organization
Organization Name:AJB ASSOCIATES
Other - Org Name:MICHAEL B SHOES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOIANO
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:724-465-9151
Mailing Address - Street 1:2510 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3233
Mailing Address - Country:US
Mailing Address - Phone:724-349-0523
Mailing Address - Fax:724-349-0524
Practice Address - Street 1:721 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3905
Practice Address - Country:US
Practice Address - Phone:724-465-9151
Practice Address - Fax:724-349-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACPED2316332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment