Organization
AMERI-FAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCI MITCHELL (PRESIDENT)
(623) 780-0400
Entity
Organization
Contact information
Practice address
22640 N 21ST AVE, PHOENIX, AZ 85027-2035
(623) 780-0400
Mailing address
22640 N 21ST AVE, PHOENIX, AZ 85027-2035
(623) 780-0400
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
0058091
NV
332BC3200X
Customized Equipment (DME)
Primary
ROC 161858 KB-01
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260390
AHCCCS
AZ
Enumeration date
12/01/2006
Last updated
11/06/2007
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