Provider Demographics
NPI:1104438316
Name:PASAMB LLC
Entity type:Organization
Organization Name:PASAMB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EKECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:646-415-0304
Mailing Address - Street 1:227 CHESTERFIELD ST S
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-7113
Mailing Address - Country:US
Mailing Address - Phone:803-226-0231
Mailing Address - Fax:
Practice Address - Street 1:227 CHESTERFIELD ST S
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-7113
Practice Address - Country:US
Practice Address - Phone:803-226-0231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAGEO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty