Organization
FASSE DABE, LLC
Active
Other names
Dabe Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIMBALL LEWIS DABE RRT (MEMBER)
(513) 573-9625
Entity
Organization
Contact information
Practice address
7537 EASY ST, MASON, OH 45040-9421
(513) 573-9625
(513) 573-9628
Mailing address
7537 EASY ST, MASON, OH 45040-9421
(513) 573-9625
(513) 573-9828
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
HMER22180
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2284200
—
OH
01
—
69000567A
INDIANA DME LICENSE
IN
01
—
HMER 22180
STATE LICENSE OHIO
OH
Enumeration date
11/08/2005
Last updated
05/25/2011
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