Provider Demographics
NPI:1972875664
Name:FORT ASHBY BUSINESS ASSOCIATES, INC
Entity Type:Organization
Organization Name:FORT ASHBY BUSINESS ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:NESTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:304-298-4404
Mailing Address - Street 1:PO BOX 1170
Mailing Address - Street 2:
Mailing Address - City:FORT ASHBY
Mailing Address - State:WV
Mailing Address - Zip Code:26719-1170
Mailing Address - Country:US
Mailing Address - Phone:304-298-4404
Mailing Address - Fax:304-298-4184
Practice Address - Street 1:10164 FRANKFORT HIGHWAY
Practice Address - Street 2:
Practice Address - City:FORT ASHBY
Practice Address - State:WV
Practice Address - Zip Code:26719-9221
Practice Address - Country:US
Practice Address - Phone:304-298-4404
Practice Address - Fax:304-298-4184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies