Healthcare Provider Details

I. General information

NPI: 1003982968
Provider Name (Legal Business Name): AMERICAN MEDICAL DEVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1788 ISLAND RD
BRISTOL VA
24201
US

IV. Provider business mailing address

1788 ISLAND ROAD
BRISTOL VA
24201
US

V. Phone/Fax

Practice location:
  • Phone: 276-642-0463
  • Fax: 276-466-4848
Mailing address:
  • Phone: 276-642-0463
  • Fax: 276-466-4848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROBERT L. MCILWAIN
Title or Position: PRESIDENT
Credential:
Phone: 276-642-0463