Provider Demographics
NPI:1396735502
Name:K L DABE AND ASSOCIATES INC
Entity type:Organization
Organization Name:K L DABE AND ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KIMBALL
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:DABE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:513-573-9625
Mailing Address - Street 1:7537 EASY ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9421
Mailing Address - Country:US
Mailing Address - Phone:513-573-9625
Mailing Address - Fax:513-573-9628
Practice Address - Street 1:7537 EASY ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-9421
Practice Address - Country:US
Practice Address - Phone:513-573-9625
Practice Address - Fax:513-573-9628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMER22180332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200169410AMedicaid
OH2196645Medicaid
IN69000563AOtherINDIANA DME LICENSE
KY90002122Medicaid
OHHMER 22180OtherOHIO DME LICENSE