Provider Demographics
NPI:1609658350
Name:IDMANN ASSOCIATES LLC
Entity Type:Organization
Organization Name:IDMANN ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NNAMDI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAECHINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-575-3647
Mailing Address - Street 1:5 LORI ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4912
Mailing Address - Country:US
Mailing Address - Phone:401-270-5469
Mailing Address - Fax:
Practice Address - Street 1:5 LORI ELLEN DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4912
Practice Address - Country:US
Practice Address - Phone:401-270-5469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility