Healthcare Provider Details

I. General information

NPI: 1881123271
Provider Name (Legal Business Name): ADVANCED DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 JERSEY LN
SPRING LAKE NJ
07762-1973
US

IV. Provider business mailing address

PO BOX 498
MARLBORO NJ
07746-0498
US

V. Phone/Fax

Practice location:
  • Phone: 732-679-2083
  • Fax:
Mailing address:
  • Phone: 732-679-2083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: PETER MATTHEW KUNTZ
Title or Position: OWNER
Credential:
Phone: 732-685-9332