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General NPI Number Information
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NPI Number | 1760860811
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Entity Type | Organization
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Legal Business Name | ADVANCE CARE DME & MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 05/09/2015
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 199 CHARMANT PL STE 2
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City | RIDGELAND
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State | MS
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Zip | 39157-4358
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Country | US
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Telephone | 601-605-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 199 CHARMANT PL STE 2
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City | RIDGELAND
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State | MS
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Zip | 39157-4358
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Country | US
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Telephone | 601-605-2380
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | MR. DOUGLAS BANKS
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Credential |
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Telephone | 601-826-3735
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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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