Provider Demographics
NPI:1033119730
Name:ADVANCED HOME MEDICAL LLC
Entity Type:Organization
Organization Name:ADVANCED HOME MEDICAL LLC
Other - Org Name:TOTAL RESPIRATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAULS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-281-4421
Mailing Address - Street 1:6665 HUNTLEY RD
Mailing Address - Street 2:SUITE N
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1044
Mailing Address - Country:US
Mailing Address - Phone:614-433-9011
Mailing Address - Fax:614-433-9013
Practice Address - Street 1:6665 HUNTLEY RD.
Practice Address - Street 2:SUITE N
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1046
Practice Address - Country:US
Practice Address - Phone:614-433-9011
Practice Address - Fax:614-433-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2267827Medicaid
OH4292140001Medicare NSC