Ameri-Fab, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

ROC 161858 KB-01 Issued in AZ

Legal business name

AMERI-FAB, LLC

Practice address

22640 N 21St Ave
Phoenix, AZ 85027-2035

Phone

(623) 780-0400

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Marci Mitchell

Title

President

Phone

(623) 780-0400

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1992873491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22640 N 21ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272035",
            "telephone_number": "623-780-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22640 N 21ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272035",
            "telephone_number": "623-780-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERI-FAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-780-0400"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AZ",
            "license": "ROC 161858 KB-01",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NV",
            "license": "0058091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "260390",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.