Provider Demographics
NPI:1679114524
Name:ANML LLC
Entity Type:Organization
Organization Name:ANML LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-718-3138
Mailing Address - Street 1:3225 N FRANKLIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-4003
Mailing Address - Country:US
Mailing Address - Phone:540-251-5002
Mailing Address - Fax:
Practice Address - Street 1:1463 W MAIN ST UNIT P2
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-5525
Practice Address - Country:US
Practice Address - Phone:540-404-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment