Provider Demographics
NPI:1477958601
Name:ADVANTAGE HOME MEDICAL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ADVANTAGE HOME MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-797-1494
Mailing Address - Street 1:850 N MERIDIAN RD
Mailing Address - Street 2:SUITE A NORTH
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44509-4020
Mailing Address - Country:US
Mailing Address - Phone:330-797-1494
Mailing Address - Fax:330-792-2161
Practice Address - Street 1:850 N MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44509-4020
Practice Address - Country:US
Practice Address - Phone:330-797-1494
Practice Address - Fax:330-792-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)