Provider Demographics
NPI:1306859830
Name:ADVANCED MEDICAL SERVICES
Entity Type:Organization
Organization Name:ADVANCED MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKALE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-910-2931
Mailing Address - Street 1:5518 WIND RIVER LN
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-9528
Mailing Address - Country:US
Mailing Address - Phone:678-910-2931
Mailing Address - Fax:
Practice Address - Street 1:5518 WIND RIVER LN
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-9528
Practice Address - Country:US
Practice Address - Phone:678-910-2931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Not Answered374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Not Answered376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty