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General NPI Number Information
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NPI Number | 1073510970
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Entity Type | Organization
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Legal Business Name | ADVANTAGE MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 211 WESTERN HILLS TRL
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City | GRANBURY
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State | TX
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Zip | 76049-6711
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Country | US
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Telephone | 817-573-4900
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Fax | 817-573-0770
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Provider Business Mailing Address
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Address Line | PO BOX 1326
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City | GRANBURY
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State | TX
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Zip | 76048-8326
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Country | US
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Telephone | 817-573-4900
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Fax | 817-573-0770
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Authorized Official
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Title or Position | OWNER
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Name | MR. CLINTON DAVIS
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Credential |
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Telephone | 817-573-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0052005
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License Number State | TX
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