Provider Demographics
NPI:1063976181
Name:ACE MEDICAL UROLOGICALS LLC
Entity type:Organization
Organization Name:ACE MEDICAL UROLOGICALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-913-8200
Mailing Address - Street 1:3501 SEVERN AVE
Mailing Address - Street 2:SUITE 20E
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-900-1187
Mailing Address - Fax:888-201-6256
Practice Address - Street 1:3501 SEVERN AVE
Practice Address - Street 2:SUITE 20E
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-900-1187
Practice Address - Fax:888-201-6256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies