Provider Demographics
NPI:1639616618
Name:ADVANCED MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-288-3167
Mailing Address - Street 1:1301 SEMINOLE BLVD STE 142
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-8182
Mailing Address - Country:US
Mailing Address - Phone:727-470-9847
Mailing Address - Fax:
Practice Address - Street 1:1301 SEMINOLE BLVD STE 142
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-8182
Practice Address - Country:US
Practice Address - Phone:727-560-2353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies