Provider Demographics
NPI:1871866988
Name:FORT ASHBY BUSINESS ASSOCIATES, INC
Entity type:Organization
Organization Name:FORT ASHBY BUSINESS ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:NESTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:NBC-HIS
Authorized Official - Phone:304-298-4404
Mailing Address - Street 1:1225A NATIONAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-729-1144
Mailing Address - Fax:
Practice Address - Street 1:1225A NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7602
Practice Address - Country:US
Practice Address - Phone:301-729-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies