Provider Demographics
NPI:1497815039
Name:ADVANCE MEDICAL ASSOCIATES,INC.
Entity Type:Organization
Organization Name:ADVANCE MEDICAL ASSOCIATES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-487-5351
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-1198
Mailing Address - Country:US
Mailing Address - Phone:205-487-5351
Mailing Address - Fax:205-487-5352
Practice Address - Street 1:2978 US HIGHWAY 43 STE 16
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5340
Practice Address - Country:US
Practice Address - Phone:205-487-5351
Practice Address - Fax:205-487-5352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009942463Medicaid
AR51541102OtherBCBS
AL009942463Medicaid