MEDICARE: ADVANCED MEDICAL, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	261QI0500X	Infusion Therapy Clinic/Center
3	261QM1300X	Multi-Specialty Clinic/Center
4	363L00000X	Nurse Practitioner
5	3336S0011X	Specialty Pharmacy
6	3336M0002X	Mail Order Pharmacy
7	251F00000X	Home Infusion Agency
8	333600000X	Pharmacy
9	3336H0001X	Home Infusion Therapy Pharmacy

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

General Provider Information

NPI Number	:	1205900958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL, LLC

Provider Business Mailing Address
First Line	:	625 S PEAR ORCHARD RD STE A
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4811
Country	:	US
Telephone Number	:	769-233-8484
Fax Number	:	769-233-8051

Provider Business Practice Location Address
First Line	:	625 S PEAR ORCHARD RD STE A
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-4836
Country	:	US
Telephone Number	:	769-233-8484
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CLINICAL PHARMACY
Name	:	CHRISTY NEELY
Credential	:	PHARMD
Telephone Number	:	769-233-8484

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	12/03/2025

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Directions to “ADVANCED MEDICAL, LLC ” Practice Location

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