Provider Demographics
NPI:1912085994
Name:BAMA MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:BAMA MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-247-7958
Mailing Address - Street 1:621 22ND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1745
Mailing Address - Country:US
Mailing Address - Phone:205-247-7958
Mailing Address - Fax:
Practice Address - Street 1:621 22ND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1745
Practice Address - Country:US
Practice Address - Phone:205-247-7958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1333332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51527406OtherBLUECROSS BLUESHIELD OF A
AL51527406OtherBLUECROSS BLUESHIELD OF A
AL51527406OtherBLUECROSS BLUESHIELD OF A