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General NPI Number Information
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NPI Number | 1679975882
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Entity Type | Organization
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Legal Business Name | ADVANCE GLOBAL USA, LLC
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 1491 DOBSON SQUARE NORTH
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City | COLUMBUS
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State | OH
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Zip | 43229
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Country | US
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Telephone | 614-436-3451
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Fax | 614-288-2699
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Provider Business Mailing Address
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Address Line | 1491 DOBSON SQUARE NORTH
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City | COLUMBUS
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State | OH
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Zip | 43229
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Country | US
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Telephone | 614-436-3451
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Fax | 614-288-2699
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Authorized Official
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Title or Position | CHAIRMAN/DIRECTOR
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Name | EBRIMA M SIDIBEH
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Credential | FCCA
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Telephone | 614-436-3451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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