Healthcare Provider Details

I. General information

NPI: 1942311873
Provider Name (Legal Business Name): ANCILLARY MANAGEMENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 BELCHER ST
CENTREVILLE AL
35042-2946
US

IV. Provider business mailing address

437 BELCHER ST PO BOX 9
CENTREVILLE AL
35042-2946
US

V. Phone/Fax

Practice location:
  • Phone: 205-926-6855
  • Fax: 205-926-3293
Mailing address:
  • Phone: 205-926-6855
  • Fax: 205-926-3293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number141
License Number StateAL

VIII. Authorized Official

Name: MR. C DENNIS GOLDMAN
Title or Position: OWNER
Credential:
Phone: 601-693-2484