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General NPI Number Information
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NPI Number | 1154137909
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Entity Type | Organization
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Legal Business Name | ADVANTAGE MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 355 W MESQUITE BLVD STE C10
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City | MESQUITE
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State | NV
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Zip | 89027-8117
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Country | US
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Telephone | 702-997-4228
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Fax | 888-775-8787
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Provider Business Mailing Address
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Address Line | 670 S HIGHWAY 89A # 89A
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City | KANAB
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State | UT
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Zip | 84741-3680
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Country | US
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Telephone | 801-831-0939
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KORY S YOUNG
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Credential |
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Telephone | 801-807-9395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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