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General NPI Number Information
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NPI Number | 1962083733
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Entity Type | Organization
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Legal Business Name | ADVANCED DME LLC
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 3315 ALMADEN EXPY STE 20
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City | SAN JOSE
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State | CA
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Zip | 95118-1557
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Country | US
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Telephone | 408-264-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 6707 38TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-1536
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Country | US
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Telephone | 727-800-9958
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Fax | 855-552-3776
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN COYLE
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Credential | DC
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Telephone | 408-396-6644
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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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