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NPI Code Detail

MEDICARE: ACE MEDICAL LLC

MEDICARE: ACE MEDICAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003039694OTHERWVBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154742328
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACE MEDICAL LLC
Provider Business Mailing Address
First Line : 2702 1ST AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25702-1340
Country : US
Telephone Number : 304-525-2211
Fax Number : 304-525-2212
Provider Business Practice Location Address
First Line : 2702 1ST AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25702-1340
Country : US
Telephone Number : 304-525-2211
Fax Number : 304-525-2212
Authorized Official
Title or Position : OWNER
Name : MR. ROBERT G MARSHALL
Credential :
Telephone Number : 304-525-2211
Provider Enumeration Date : 12/13/2013
Last Update Date : 09/05/2014

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Directions to “ACE MEDICAL LLC ” Practice Location

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