MEDICARE: ADVANCED HEALTH SERVICES 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	251E00000X	Home Health Agency	251E00000X	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215921101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTH SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 1996
Second Line	:
City	:	PULASKI
State	:	VA
Zip	:	24301-1910
Country	:	US
Telephone Number	:	540-994-9811
Fax Number	:	540-994-9760

Provider Business Practice Location Address
First Line	:	58 N WASHINGTON AVE
Second Line	:	SUITE 516
City	:	PULASKI
State	:	VA
Zip	:	24301-5732
Country	:	US
Telephone Number	:	540-994-9811
Fax Number	:	540-994-9760

Authorized Official
Title or Position	:	COO
Name	:	MRS. GLORIA J KEEN
Credential	:
Telephone Number	:	615-690-4427

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	05/02/2008

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