Provider Demographics
NPI:1437453222
Name:AJ'S COMPLETE BATHROOM REMODELING
Entity Type:Organization
Organization Name:AJ'S COMPLETE BATHROOM REMODELING
Other - Org Name:REBATH OF LINCOLN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-510-0218
Mailing Address - Street 1:20512 ANTLER CIR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2084
Mailing Address - Country:US
Mailing Address - Phone:402-510-0218
Mailing Address - Fax:402-933-8699
Practice Address - Street 1:20512 ANTLER CIR
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2084
Practice Address - Country:US
Practice Address - Phone:402-510-0218
Practice Address - Fax:402-933-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE001010591303332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies