Provider Demographics
NPI:1134172703
Name:THI ADVANTAGE DME, LLC
Entity type:Organization
Organization Name:THI ADVANTAGE DME, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-773-1176
Mailing Address - Street 1:930 RIDGEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9390
Mailing Address - Country:US
Mailing Address - Phone:410-773-1000
Mailing Address - Fax:
Practice Address - Street 1:920 RIDGEBROOK RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9390
Practice Address - Country:US
Practice Address - Phone:410-773-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0075248Medicaid
IA0588848Medicaid
OH2540487Medicaid
KY90009044Medicaid
AL0099743650Medicaid
CO72401770Medicaid
DE1000034769Medicaid
NM06872310Medicaid
PA1011297720001Medicaid
AZ887036Medicaid
OH2540487Medicaid
KY90009044Medicaid