MEDICARE: ADVANCED HOME MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies		OH

General Provider Information

NPI Number	:	1033119730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HOME MEDICAL LLC

Provider Business Mailing Address
First Line	:	6414 S 118TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3576
Country	:	US
Telephone Number	:	402-933-6412
Fax Number	:	402-281-4490

Provider Business Practice Location Address
First Line	:	9039 ANTARES AVE STE A1
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43240-4067
Country	:	US
Telephone Number	:	614-433-9011
Fax Number	:	614-433-9013

Authorized Official
Title or Position	:	COMPLIANCE OFFICER
Name	:	SHEILA ROBERSON
Credential	:
Telephone Number	:	602-818-5258

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/12/2025

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Directions to “ADVANCED HOME MEDICAL LLC ” Practice Location

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