Provider Demographics
NPI: | 1073747671 |
---|---|
Name: | AEROSOL PLUS, INC. |
Entity type: | Organization |
Organization Name: | AEROSOL PLUS, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WERNER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GUTMANN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 877-795-6452 |
Mailing Address - Street 1: | 792 FOLLY RD |
Mailing Address - Street 2: | SUITE 1 |
Mailing Address - City: | CHARLESTON |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29412-3476 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 843-408-4307 |
Mailing Address - Fax: | 866-489-2738 |
Practice Address - Street 1: | 329 BUSINESS CIR |
Practice Address - Street 2: | SUITE C |
Practice Address - City: | PELHAM |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35124-1711 |
Practice Address - Country: | US |
Practice Address - Phone: | 205-386-8815 |
Practice Address - Fax: | 866-945-9269 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-05-11 |
Last Update Date: | 2010-08-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AL | 118807 | Medicaid | |
AL | 118807 | Medicaid |