Provider Demographics
NPI:1770131013
Name:ARAN, JACE
Entity type:Individual
Prefix:
First Name:JACE
Middle Name:
Last Name:ARAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 N FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3108
Mailing Address - Country:US
Mailing Address - Phone:251-473-4200
Mailing Address - Fax:
Practice Address - Street 1:58 N FLORIDA ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3108
Practice Address - Country:US
Practice Address - Phone:251-473-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009936408Medicaid