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General NPI Number Information
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NPI Number | 1033193560
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Entity Type | Organization
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Legal Business Name | UBN CORPORATION
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 W 79TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5439
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Country | US
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Telephone | 219-756-6607
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Fax | 219-756-6627
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Provider Business Mailing Address
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Address Line | 100 W 79TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5439
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Country | US
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Telephone | 219-756-6607
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Fax | 219-756-6627
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BASIL N UBANWA
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Credential | N/A
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Telephone | 219-756-6607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 48001521A
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License Number State | IN
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