Provider Demographics
NPI:1609838721
Name:ADVANTAGE HOME MEDICAL COMPANY
Entity Type:Organization
Organization Name:ADVANTAGE HOME MEDICAL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-627-9669
Mailing Address - Street 1:7002 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5729
Mailing Address - Country:US
Mailing Address - Phone:864-627-9669
Mailing Address - Fax:864-627-9670
Practice Address - Street 1:7002 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5729
Practice Address - Country:US
Practice Address - Phone:864-627-9669
Practice Address - Fax:864-627-9670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC65008374332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2674Medicaid
SC1024492OtherACM PROVIDER NUMBER
SCDE2674Medicaid