Provider Demographics
NPI:1598909749
Name:AM-BATH, LLC
Entity Type:Organization
Organization Name:AM-BATH, LLC
Other - Org Name:RE-BATH, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-844-2596
Mailing Address - Street 1:421 W ALAMEDA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2045
Mailing Address - Country:US
Mailing Address - Phone:480-844-2596
Mailing Address - Fax:480-833-7199
Practice Address - Street 1:421 W ALAMEDA DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2045
Practice Address - Country:US
Practice Address - Phone:480-844-2596
Practice Address - Fax:480-833-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies