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NPI Code Detail

MEDICARE: ADVANTAGEOUS MD LLC

MEDICARE: ADVANTAGEOUS MD LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1235370594
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANTAGEOUS MD LLC
Provider Business Mailing Address
First Line : 1728 VIRGINIA BEACH BLVD
Second Line : SUITE 115
City : VIRGINIA BEACH
State : VA
Zip : 23454-4533
Country : US
Telephone Number : 757-351-0832
Fax Number : 800-715-4039
Provider Business Practice Location Address
First Line : 1728 VIRGINIA BEACH BLVD
Second Line : SUITE 115
City : VIRGINIA BEACH
State : VA
Zip : 23454-4533
Country : US
Telephone Number : 757-351-0832
Fax Number : 800-715-4039
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOHN HEROD
Credential :
Telephone Number : 757-351-0832
Provider Enumeration Date : 03/17/2009
Last Update Date : 05/21/2010

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Directions to “ADVANTAGEOUS MD LLC ” Practice Location

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