Provider Demographics
NPI:1043269723
Name:ADVANCED MULTIMEDIA DEVICES INC
Entity Type:Organization
Organization Name:ADVANCED MULTIMEDIA DEVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES AND CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SOMCHAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-531-8888
Mailing Address - Street 1:95 SHERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-1717
Mailing Address - Country:US
Mailing Address - Phone:631-531-8888
Mailing Address - Fax:631-531-8811
Practice Address - Street 1:95 SHERWOOD AVE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-1717
Practice Address - Country:US
Practice Address - Phone:631-531-8888
Practice Address - Fax:631-531-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1160083Medicaid
IN200497400AMedicaid
MD000267400Medicaid
CT003119311Medicaid
DE1000036135Medicaid
ME161570000Medicaid
AZ807480Medicaid
KY90006578Medicaid
IA0583435Medicaid
MS08887244Medicaid
ID806676400Medicaid
AL009947225Medicaid
NE10025029200Medicaid
KS100644620BMedicaid
MN923124200Medicaid
MI4542060Medicaid
MT0561833Medicaid
MO626095004Medicaid
LA1160083Medicaid
IN200497400AMedicaid