Provider Demographics
NPI:1629205125
Name:ADVANCE MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:ADVANCE MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SULTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-409-9200
Mailing Address - Street 1:8340 VAN NUYS BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-3693
Mailing Address - Country:US
Mailing Address - Phone:818-409-9200
Mailing Address - Fax:818-409-0908
Practice Address - Street 1:8340 VAN NUYS BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-3693
Practice Address - Country:US
Practice Address - Phone:818-409-9200
Practice Address - Fax:818-409-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20090305332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1629205125Medicaid
CA6445290001Medicare NSC