Provider Demographics
NPI:1942317367
Name:ACE HOME MEDICAL LLC
Entity Type:Organization
Organization Name:ACE HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIKE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANIUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-745-5751
Mailing Address - Street 1:2214 GATEWAY DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6832
Mailing Address - Country:US
Mailing Address - Phone:334-745-5751
Mailing Address - Fax:334-745-5775
Practice Address - Street 1:2214 GATEWAY DR
Practice Address - Street 2:SUITE G
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6832
Practice Address - Country:US
Practice Address - Phone:334-745-5751
Practice Address - Fax:334-745-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL671332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009936459Medicaid
AL51533439OtherALABAMA BCBS NUMBER
5614330002Medicare NSC