Provider Demographics
NPI:1659521078
Name:ADVANCED MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:ADVANCED MEDICAL SUPPLIES
Other - Org Name:ADVANCED MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:CFTS
Authorized Official - Phone:956-618-1991
Mailing Address - Street 1:4209 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4143
Mailing Address - Country:US
Mailing Address - Phone:956-618-1991
Mailing Address - Fax:
Practice Address - Street 1:4209 N 22ND ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4143
Practice Address - Country:US
Practice Address - Phone:956-618-1991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32027032021OtherTEXAS SALES TAX PERMIT