Provider Demographics
NPI:1508015330
Name:ADB
Entity Type:Organization
Organization Name:ADB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
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 # 3
Mailing Address - Street 2:
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:513-202-1371
Practice Address - Street 1:121 HARRISON AVE # 3
Practice Address - Street 2:
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:513-202-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies