Provider Demographics
NPI:1205415080
Name:ADVANCED MEDICAL LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-312-1445
Mailing Address - Street 1:619 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-5405
Mailing Address - Country:US
Mailing Address - Phone:606-312-1445
Mailing Address - Fax:
Practice Address - Street 1:202 N HILL ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1360
Practice Address - Country:US
Practice Address - Phone:606-312-1445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies