Provider Demographics
NPI:1598087918
Name:ADVANCED MEDICAL EQUIPMENT AND SUPPLIES, LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL EQUIPMENT AND SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:VERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-656-2568
Mailing Address - Street 1:1013 E MCNEESE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-5837
Mailing Address - Country:US
Mailing Address - Phone:337-656-2568
Mailing Address - Fax:337-564-5058
Practice Address - Street 1:1013 E MCNEESE ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-5837
Practice Address - Country:US
Practice Address - Phone:337-656-2568
Practice Address - Fax:337-564-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies