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General NPI Number Information
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NPI Number | 1821997644
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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 | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 4510 S 900 W STE 4
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City | RIVERDALE
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State | UT
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Zip | 84405-3664
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Country | US
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Telephone | 801-392-2463
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Fax |
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Provider Business Mailing Address
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Address Line | 590 GREENWOOD DR
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City | BRIGHAM CITY
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State | UT
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Zip | 84302-4736
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Country | US
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Telephone | 435-734-0488
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Fax | 435-734-0489
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Authorized Official
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Title or Position | VP
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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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