Healthcare Provider Details
I. General information
NPI: 1700116746
Provider Name (Legal Business Name): ADVENT MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2010
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
780 LYNNHAVEN PKWY STE 140
VIRGINIA BEACH VA
23452-7332
US
IV. Provider business mailing address
780 LYNNHAVEN PKWY STE 140
VIRGINIA BEACH VA
23452-7332
US
V. Phone/Fax
- Phone: 877-530-6123
- Fax: 803-753-9699
- Phone: 877-530-6123
- Fax: 803-753-9699
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
BRIAN
BOURONICH
Title or Position: CEO/OWNER
Credential: COF
Phone: 843-597-2264