Provider Demographics
NPI:1093225617
Name:ADVANCED MEDICAL EQUIPMENT OF DELAWARE, LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL EQUIPMENT OF DELAWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZEBUN
Authorized Official - Middle Name:
Authorized Official - Last Name:NISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-907-5756
Mailing Address - Street 1:1103 LA GRANGE PKWY
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3836
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:379 WALMART DR STE B
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1365
Practice Address - Country:US
Practice Address - Phone:410-714-2831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies