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General NPI Number Information
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NPI Number | 1104370105
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Entity Type | Organization
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Legal Business Name | AABON 2, INC
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 136 E REYNOLDS ST
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City | OZARK
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State | AL
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Zip | 36360-1530
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Country | US
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Telephone | 334-774-5553
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Fax | 334-445-1736
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Provider Business Mailing Address
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Address Line | 136 E REYNOLDS ST
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City | OZARK
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State | AL
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Zip | 36360-1530
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Country | US
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Telephone | 334-774-5553
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Fax | 334-445-1736
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ROBERT E HARRY
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Credential | ATP/SMS
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Telephone | 334-733-8500
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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 | 82162
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License Number State | AL
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