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General NPI Number Information
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NPI Number | 1861674871
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL SOLUTIONS LLC
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 13400 LAKEFRONT DR
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City | EARTH CITY
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State | MO
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Zip | 63045-1516
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Country | US
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Telephone | 314-291-2900
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Fax | 800-508-8491
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Provider Business Mailing Address
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Address Line | PO BOX 879
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City | BRIDGETON
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State | MO
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Zip | 63044-0879
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Country | US
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Telephone | 314-291-2900
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Fax | 800-508-8491
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | EDWIN L WARREN
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Credential |
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Telephone | 314-291-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2005037494
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License Number State | MO
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