Provider Demographics
NPI:1508531682
Name:ADVANCE GROUP SERVICES
Entity Type:Organization
Organization Name:ADVANCE GROUP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:214-484-3347
Mailing Address - Street 1:1053 S PEPPERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134-2038
Mailing Address - Country:US
Mailing Address - Phone:214-484-3347
Mailing Address - Fax:
Practice Address - Street 1:1053 S PEPPERIDGE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75134-2038
Practice Address - Country:US
Practice Address - Phone:214-484-3347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX46043153OtherDRIVER LICENSE