Provider Demographics
NPI:1538128293
Name:ADVANCED MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL EQUIPMENT, LLC
Other - Org Name:PEDIATRIC HOME SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAMEO
Authorized Official - Middle Name:KAE
Authorized Official - Last Name:ZEHNDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-642-1825
Mailing Address - Street 1:426 ALEXANDERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3658
Mailing Address - Country:US
Mailing Address - Phone:937-534-1080
Mailing Address - Fax:937-534-1081
Practice Address - Street 1:426 ALEXANDERSVILLE RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3658
Practice Address - Country:US
Practice Address - Phone:937-534-1080
Practice Address - Fax:937-534-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57187036332B00000X
332BC3200X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2494162Medicaid
5162040001Medicare ID - Type UnspecifiedPROVIDER NUMBER