Healthcare Provider Details

I. General information

NPI: 1316890239
Provider Name (Legal Business Name): AMWW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 E PARIS AVE SE STE B
GRAND RAPIDS MI
49546-6138
US

IV. Provider business mailing address

2675 E PARIS AVE SE STE B
GRAND RAPIDS MI
49546-6138
US

V. Phone/Fax

Practice location:
  • Phone: 616-818-9552
  • Fax: 616-719-0292
Mailing address:
  • Phone: 616-818-9552
  • Fax: 616-719-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name: ALI AQEL
Title or Position: CEO
Credential: RETAIL
Phone: 616-818-9552