Provider Demographics
NPI:1942526215
Name:ADVANCED DEVICE ACCESS MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ADVANCED DEVICE ACCESS MANAGEMENT, LLC
Other - Org Name:ADAM
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-507-3838
Mailing Address - Street 1:PO BOX 8457
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13505
Mailing Address - Country:US
Mailing Address - Phone:888-805-2326
Mailing Address - Fax:315-849-2733
Practice Address - Street 1:1508 GENESEE STREET
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13505
Practice Address - Country:US
Practice Address - Phone:315-507-3838
Practice Address - Fax:315-849-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies