Provider Demographics
NPI:1164871950
Name:ANCILLARY ADVANTAGE, INC.
Entity Type:Organization
Organization Name:ANCILLARY ADVANTAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-371-8927
Mailing Address - Street 1:1255 W 15TH ST
Mailing Address - Street 2:SUITE 540
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4450 BELDEN VILLAGE ST NW
Practice Address - Street 2:SUITE 305
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2552
Practice Address - Country:US
Practice Address - Phone:800-565-0445
Practice Address - Fax:888-871-5609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies