Provider Demographics
NPI:1073828067
Name:ADVANTAGE ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:ADVANTAGE ORTHOPEDICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-298-1050
Mailing Address - Street 1:174 BATH NAZARETH HWY
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9080
Mailing Address - Country:US
Mailing Address - Phone:484-298-1050
Mailing Address - Fax:484-222-2787
Practice Address - Street 1:174 BATH NAZARETH HWY
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-2060
Practice Address - Country:US
Practice Address - Phone:484-298-1050
Practice Address - Fax:484-222-2787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6485850001Medicare NSC