Provider Demographics
NPI:1750067682
Name:ADVANCED HOME MEDICAL, LLC
Entity type:Organization
Organization Name:ADVANCED HOME MEDICAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAULS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-281-4421
Mailing Address - Street 1:6414 S. 118TH STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:69813
Mailing Address - Country:US
Mailing Address - Phone:402-281-4421
Mailing Address - Fax:
Practice Address - Street 1:905 LOVERS LN STE 200
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-7114
Practice Address - Country:US
Practice Address - Phone:270-715-4441
Practice Address - Fax:270-715-4442
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED HOME MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-26
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies