MEDICARE: ADVANCED MEDICAL EQUIPMENT AND SUPPLIES, 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		LA

General Provider Information

NPI Number	:	1598087918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL EQUIPMENT AND SUPPLIES, LLC

Provider Business Mailing Address
First Line	:	1013 E MCNEESE ST
Second Line	:	SUITE B
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-5837
Country	:	US
Telephone Number	:	337-656-2568
Fax Number	:	337-564-5058

Provider Business Practice Location Address
First Line	:	1013 E MCNEESE ST
Second Line	:	SUITE B
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-5837
Country	:	US
Telephone Number	:	337-656-2568
Fax Number	:	337-564-5058

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ADAM K. VERON
Credential	:
Telephone Number	:	337-656-2568

Provider Enumeration Date	:	02/26/2010
Last Update Date	:	03/27/2013

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