Provider Demographics
NPI:1437301652
Name:ADVANTAGE MEDICAL EQUIPMANT & SUPPLY LLC
Entity Type:Organization
Organization Name:ADVANTAGE MEDICAL EQUIPMANT & SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-306-2566
Mailing Address - Street 1:808 POWDERSVILLE RD STE 15
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-1968
Mailing Address - Country:US
Mailing Address - Phone:864-306-2566
Mailing Address - Fax:864-306-1123
Practice Address - Street 1:808 POWDERSVILLE RD STE 15
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1968
Practice Address - Country:US
Practice Address - Phone:864-306-2566
Practice Address - Fax:864-306-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies