Provider Demographics
NPI:1477859304
Name:VERSA BATH SEAT, LLC
Entity type:Organization
Organization Name:VERSA BATH SEAT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-571-9990
Mailing Address - Street 1:3477 CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2745
Mailing Address - Country:US
Mailing Address - Phone:256-571-9990
Mailing Address - Fax:256-571-7539
Practice Address - Street 1:106 HIDDEN DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35769-9322
Practice Address - Country:US
Practice Address - Phone:256-571-9990
Practice Address - Fax:256-571-7539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies