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General NPI Number Information
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NPI Number | 1235370594
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Entity Type | Organization
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Legal Business Name | ADVANTAGEOUS MD LLC
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 05/21/2010
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Provider Practice Location Address
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Address Line | 1728 VIRGINIA BEACH BLVD SUITE 115
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4533
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Country | US
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Telephone | 757-351-0832
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Fax | 800-715-4039
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Provider Business Mailing Address
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Address Line | 1728 VIRGINIA BEACH BLVD SUITE 115
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4533
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Country | US
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Telephone | 757-351-0832
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Fax | 800-715-4039
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN HEROD
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Credential |
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Telephone | 757-351-0832
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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 |
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License Number State |
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