Provider Demographics
NPI:1104839356
Name:ADVANCED HEALTH PRODUCTS INC
Entity Type:Organization
Organization Name:ADVANCED HEALTH PRODUCTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:AMEDEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-872-1469
Mailing Address - Street 1:210 GEMINI CT
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360
Mailing Address - Country:US
Mailing Address - Phone:985-872-1469
Mailing Address - Fax:985-872-1467
Practice Address - Street 1:210 GEMINI CT
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-872-1469
Practice Address - Fax:985-872-1467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0C13075332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1657433Medicaid
LA1657433Medicaid