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General NPI Number Information
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NPI Number | 1497717235
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Entity Type | Organization
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Legal Business Name | ADVANTAGE HOME MEDICAL EQUIPMENT, INC
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 911 W 55TH ST
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-6628
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Country | US
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Telephone | 708-579-5790
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Fax | 708-579-1384
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Provider Business Mailing Address
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Address Line | 911 W 55TH ST
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-6628
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Country | US
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Telephone | 708-579-5790
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Fax | 708-579-1384
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL S ZEZULAK
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Credential |
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Telephone | 708-579-5790
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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 | 203000326
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 203000326
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License Number State | IL
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