Provider Demographics
NPI:1912212747
Name:ORTHO ADVANCE LLC
Entity Type:Organization
Organization Name:ORTHO ADVANCE LLC
Other - Org Name:ORTHO ADVANCE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-456-5600
Mailing Address - Street 1:25003 PITKIN RD
Mailing Address - Street 2:SUITE E500
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:122 MEDICAL PARK LN
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4902
Practice Address - Country:US
Practice Address - Phone:832-456-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies