Provider Demographics
NPI:1124471024
Name:A C STEVENS ENTERPRISES LLC
Entity type:Organization
Organization Name:A C STEVENS ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-420-9395
Mailing Address - Street 1:9660 JADLOS DR
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1683
Mailing Address - Country:US
Mailing Address - Phone:419-420-9395
Mailing Address - Fax:
Practice Address - Street 1:9660 JADLOS DR
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1683
Practice Address - Country:US
Practice Address - Phone:419-420-9395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No347C00000XTransportation ServicesPrivate Vehicle