Provider Demographics
NPI:1285104653
Name:SASS, RONALD MICHAEL
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MICHAEL
Last Name:SASS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 WHIPPOORWILL DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1124
Mailing Address - Country:US
Mailing Address - Phone:205-600-5637
Mailing Address - Fax:205-989-4004
Practice Address - Street 1:721 WHIPPOORWILL DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1124
Practice Address - Country:US
Practice Address - Phone:205-600-5637
Practice Address - Fax:205-989-4004
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR010195320332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies