MEDICARE: ADVANCED THERAPEUTICS, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1205896875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED THERAPEUTICS, INC

Provider Business Mailing Address
First Line	:	6304 WOODSIDE CT
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3216
Country	:	US
Telephone Number	:	410-290-9983
Fax Number	:	410-290-9985

Provider Business Practice Location Address
First Line	:	46573 CONTINENTAL DR
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48047-5207
Country	:	US
Telephone Number	:	800-929-1867
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. ROBERT ROTH
Credential	:
Telephone Number	:	410-290-9983

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	08/22/2020

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