Healthcare Provider Details

I. General information

NPI: 1851565592
Provider Name (Legal Business Name): ADVANCE MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 N MILDRED RD
CORTEZ CO
81321-2418
US

IV. Provider business mailing address

1268 S 1380 W
OREM UT
84058-4911
US

V. Phone/Fax

Practice location:
  • Phone: 970-565-4200
  • Fax: 970-565-2786
Mailing address:
  • Phone: 801-373-1010
  • Fax: 801-373-2217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. GORDON RIDLEY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 801-373-1010