Organization
ACE HOME MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE CELESTINE OMALU (ADMINISTRATOR)
(334) 745-5751
Entity
Organization
Contact information
Practice address
2214 GATEWAY DR, SUITE G, OPELIKA, AL 36801-1500
(334) 745-5751
(334) 745-5775
Mailing address
4807 20TH AVE, VALLEY, AL 36854-3548
(334) 756-8790
(334) 756-8792
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
672
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51533440
ALABAMA BCBS
AL
Enumeration date
09/01/2006
Last updated
08/22/2020
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