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NPI Code Detail

MEDICARE: ADVANTAGE MEDICAL, INC.

MEDICARE: ADVANTAGE MEDICAL, 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
1332B00000XDurable Medical Equipment & Medical SuppliesMO

General Provider Information

NPI Number : 1861418261
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANTAGE MEDICAL, INC.
Provider Business Mailing Address
First Line : 11110 LINDBERGH BUSINESS CT
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63123-7810
Country : US
Telephone Number : 314-845-8841
Fax Number : 314-845-8843
Provider Business Practice Location Address
First Line : 11110 LINDBERGH BUSINESS CT
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63123-7810
Country : US
Telephone Number : 314-845-8841
Fax Number : 314-845-8843
Authorized Official
Title or Position : PRESIDENT
Name : CHRISTOPHER LEARA
Credential :
Telephone Number : 314-845-8841
Provider Enumeration Date : 07/15/2006
Last Update Date : 08/22/2020

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