=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093782054
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVANCED HOME MEDICAL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 152 FUGATE STREET
-----------------------------------------------------
City | DUFFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-431-2275
-----------------------------------------------------
Fax | 276-431-2276
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 483
-----------------------------------------------------
City | DUFFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24244-0483
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-431-2275
-----------------------------------------------------
Fax | 276-431-2276
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | MR. BOB FRANKLIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-257-2047
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------