MEDICARE: ADVOCATE MEDICAL SUPPLY & MOBILITY, 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

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	:	1841238805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCATE MEDICAL SUPPLY & MOBILITY, INC.

Provider Business Mailing Address
First Line	:	805 W 2ND ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-2117
Country	:	US
Telephone Number	:	501-372-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 W 2ND ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-2117
Country	:	US
Telephone Number	:	501-372-4444
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	MR. KEITH GOODNER
Credential	:
Telephone Number	:	501-372-4444

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	01/11/2010

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