Provider Demographics
NPI:1902361439
Name:ADVANCED HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-534-8306
Mailing Address - Street 1:100 ASMA BLVD. MAILBOX 588
Mailing Address - Street 2:SUITE 203-E
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-534-8306
Mailing Address - Fax:337-534-8316
Practice Address - Street 1:100 ASMA BLVD
Practice Address - Street 2:STE 212-E
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3858
Practice Address - Country:US
Practice Address - Phone:337-534-8306
Practice Address - Fax:337-534-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies