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NPI Code Detail

MEDICARE: AMDD,INC

MEDICARE: AMDD,INC
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
1310400000XAssisted Living Facility2083OH

General Provider Information

NPI Number : 1881730059
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMDD,INC
Provider Business Mailing Address
First Line : 2026 STATE ROUTE 45
Second Line :
City : AUSTINBURG
State : OH
Zip : 44010-9711
Country : US
Telephone Number : 440-239-4300
Fax Number : 440-239-4301
Provider Business Practice Location Address
First Line : 2026 STATE ROUTE 45
Second Line :
City : AUSTINBURG
State : OH
Zip : 44010-9711
Country : US
Telephone Number : 440-239-4300
Fax Number : 440-239-4301
Authorized Official
Title or Position : AR MANAGER
Name : ADAM J WHITE
Credential : MBA
Telephone Number : 614-416-2638
Provider Enumeration Date : 01/29/2007
Last Update Date : 08/22/2020

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Practice Location Address:
2026 STATE ROUTE 45
AUSTINBURG, OH
44010-9711
Practice Phone: 440-275-3019
Practice Fax: 440-275-3366
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44010-9711
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Practice Location Address:
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44010-9711
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1346718533 — DANNY LOUIS PETTIT M.A., CCC-SLP
Practice Location Address:
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Directions to “AMDD,INC ” Practice Location

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