MEDICARE: ADVANCED MEDICAL TECHNOLOGIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	0000000657	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7316377	OTHER	TN	AETNA
3	4019590	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1194728782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL TECHNOLOGIES, INC.

Provider Business Mailing Address
First Line	:	5306 N MIDDLEBROOK PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37921-5910
Country	:	US
Telephone Number	:	865-588-2010
Fax Number	:	865-584-0710

Provider Business Practice Location Address
First Line	:	5306 N MIDDLEBROOK PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37921-5910
Country	:	US
Telephone Number	:	865-588-2010
Fax Number	:	865-584-0710

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DALLAS JONES
Credential	:
Telephone Number	:	865-588-2010

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	08/22/2020

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