Provider Demographics
NPI:1326070806
Name:ADVANCED MEDICAL ENTERPRISES, LP
Entity Type:Organization
Organization Name:ADVANCED MEDICAL ENTERPRISES, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CONTRACTING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHELLI
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-285-4914
Mailing Address - Street 1:PO BOX 5765
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-5765
Mailing Address - Country:US
Mailing Address - Phone:405-285-7126
Mailing Address - Fax:405-285-7125
Practice Address - Street 1:428 W 15TH ST STE 1
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3690
Practice Address - Country:US
Practice Address - Phone:405-330-1633
Practice Address - Fax:405-341-9412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK241767332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4569850003Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER