Provider Demographics
NPI:1134288996
Name:ADVANCED MEDICAL SOLUTIONS INC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-668-8802
Mailing Address - Street 1:623 OLD HICKORY BLVD STE G
Mailing Address - Street 2:STE G
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2985
Mailing Address - Country:US
Mailing Address - Phone:731-668-8802
Mailing Address - Fax:731-660-4802
Practice Address - Street 1:623 OLD HICKORY BLVD
Practice Address - Street 2:STE G
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2906
Practice Address - Country:US
Practice Address - Phone:731-668-8802
Practice Address - Fax:731-660-4802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4609761332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454202Medicaid
TN4392970001Medicare NSC