Provider Demographics
NPI:1124032446
Name:ADVANCE MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:ADVANCE MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-366-4244
Mailing Address - Street 1:1006 TOP ST
Mailing Address - Street 2:SUITE #C
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7642
Mailing Address - Country:US
Mailing Address - Phone:601-939-0702
Mailing Address - Fax:601-981-3640
Practice Address - Street 1:1006 TOP ST
Practice Address - Street 2:SUITE #C
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7642
Practice Address - Country:US
Practice Address - Phone:601-939-0702
Practice Address - Fax:601-981-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07037/11.1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies