Provider Demographics
NPI:1922005479
Name:ADVANCED HOSPITAL & MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:ADVANCED HOSPITAL & MEDICAL SUPPLIES, INC.
Other - Org Name:SAME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZELMA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:FRATICELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-890-1410
Mailing Address - Street 1:PO BOX 60401
Mailing Address - Street 2:PMB 40
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-4010
Mailing Address - Country:US
Mailing Address - Phone:787-890-1410
Mailing Address - Fax:787-890-4006
Practice Address - Street 1:493 AVE. KENNEDY
Practice Address - Street 2:PDO. SAN ANTONIO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-890-1410
Practice Address - Fax:787-890-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1063990001Medicare NSC