Organization Name: | ANTONINO ENTERPRISES LLC |
NPI Number: | 1487968772 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTHONY THOMAS VITALE (OWNER) |
Mailing Address: | 211 Commerce St Cadiz |
State: | KY US |
Postal Code: | 422119225 |
Phone Number: | 2705223957 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2010 |
NPI Last Update Date: | 08/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 5157 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |