Provider Demographics
NPI:1366221871
Name:AMSDEN MANAGEMENT LLC
Entity type:Organization
Organization Name:AMSDEN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-432-2228
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:MO
Mailing Address - Zip Code:63650-0012
Mailing Address - Country:US
Mailing Address - Phone:573-432-2228
Mailing Address - Fax:573-432-2271
Practice Address - Street 1:316 S MAIN ST
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:MO
Practice Address - Zip Code:63650-1407
Practice Address - Country:US
Practice Address - Phone:573-432-2228
Practice Address - Fax:573-432-2271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care