Provider Demographics
NPI:1194196535
Name:ADVANCE TELEHEALTH CONSULTING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ADVANCE TELEHEALTH CONSULTING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-565-0843
Mailing Address - Street 1:PO BOX 91955
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70509
Mailing Address - Country:US
Mailing Address - Phone:337-565-0843
Mailing Address - Fax:337-205-4150
Practice Address - Street 1:1001 W. PINHOOK ROAD
Practice Address - Street 2:BUILDING 3 SUITE 219
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-565-0843
Practice Address - Fax:337-205-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty