Mary Ann Wallace

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

License

20060784 Issued in OH

Legal business name

MARY ANN WALLACE

Doing business as

Ahlers Catering

Practice address

900 Troy Street
Dayton, OH 45404

Phone

(937) 443-0405

Fax

(937) 454-0390

NPI assigned

Jan 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary Ann Wallace

Title

Ceo Owner Operator

Phone

(937) 443-0405

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ahlers Catering Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1124172036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TROY STREET",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45404",
            "telephone_number": "937-443-0405",
            "fax_number": "937-454-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TROY STREET",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45404",
            "telephone_number": "937-443-0405",
            "fax_number": "937-454-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN WALLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CEO OWNER OPERATOR",
        "authorized_official_telephone_number": "937-443-0405",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "OH",
            "license": "20060784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0959379",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ahlers Catering",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Delivered Meals in Dayton, OH
• Providers in Dayton, OH by specialty
• Home Delivered Meals in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.