Healthcare Provider Details

I. General information

NPI: 1861413205
Provider Name (Legal Business Name): ANCILLARY SERVICES MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 NORTH SUMMIT STREET ATTN: APRIL TERRY
TOLEDO OH
43604-2615
US

IV. Provider business mailing address

333 NORTH SUMMIT STREET ATTN: APRIL TERRY
TOLEDO OH
43604-2615
US

V. Phone/Fax

Practice location:
  • Phone: 419-252-6011
  • Fax: 800-375-5492
Mailing address:
  • Phone: 419-252-6011
  • Fax: 800-375-5492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL H KIGHT
Title or Position: PRESIDENT
Credential:
Phone: 419-252-5722