MEDICARE: ADVANCED MEDICAL EQUIPMENT 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	332B00000X	Durable Medical Equipment & Medical Supplies

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	:	1417959396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	PO BOX 1095
Second Line	:
City	:	GUTHRIE
State	:	OK
Zip	:	73044-1095
Country	:	US
Telephone Number	:	405-282-6285
Fax Number	:	405-282-5731

Provider Business Practice Location Address
First Line	:	1318 E OKLAHOMA AVE
Second Line	:
City	:	GUTHRIE
State	:	OK
Zip	:	73044-3757
Country	:	US
Telephone Number	:	405-282-6285
Fax Number	:	405-282-5731

Authorized Official
Title or Position	:	MEMBER
Name	:	MRS. TANDIE HASTINGS
Credential	:
Telephone Number	:	405-282-6285

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	04/19/2012

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Directions to “ADVANCED MEDICAL EQUIPMENT LLC ” Practice Location

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