Provider Demographics
NPI:1831287150
Name:ADVANCED HOME MEDICAL INC
Entity Type:Organization
Organization Name:ADVANCED HOME MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-886-2544
Mailing Address - Street 1:2212 FORT CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4665
Mailing Address - Country:US
Mailing Address - Phone:270-886-2544
Mailing Address - Fax:270-881-4799
Practice Address - Street 1:2212 FORT CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-4665
Practice Address - Country:US
Practice Address - Phone:270-886-2544
Practice Address - Fax:270-881-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90006743Medicaid
KY000000301041OtherBLUE CROSS/BLUE SHIELD
KY000000301041OtherBLUE CROSS/BLUE SHIELD