Provider Demographics
NPI:1750627774
Name:ALLIED HEALTH ADVANTAGE
Entity type:Organization
Organization Name:ALLIED HEALTH ADVANTAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEADLING
Authorized Official - Suffix:
Authorized Official - Credentials:CFOM, COTA/L, CLT
Authorized Official - Phone:207-680-9155
Mailing Address - Street 1:120 DRUMMOND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5778
Mailing Address - Country:US
Mailing Address - Phone:207-680-9155
Mailing Address - Fax:207-680-9160
Practice Address - Street 1:120 DRUMMOND AVE STE 2
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5778
Practice Address - Country:US
Practice Address - Phone:207-680-9155
Practice Address - Fax:207-680-9160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME6734110001Medicare NSC