Provider Demographics
NPI:1144843723
Name:ANANKELABS USA, LLC
Entity type:Organization
Organization Name:ANANKELABS USA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-473-5298
Mailing Address - Street 1:7875 SW 104TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2642
Mailing Address - Country:US
Mailing Address - Phone:786-473-5298
Mailing Address - Fax:
Practice Address - Street 1:7875 SW 104TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2642
Practice Address - Country:US
Practice Address - Phone:786-473-5298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies