MEDICARE: ADVANCED MEDICAL ENTERPRISES LP

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

General Provider Information

NPI Number	:	1902045297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MEDICAL ENTERPRISES LP

Provider Business Mailing Address
First Line	:	PO BOX 5765
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73083-5765
Country	:	US
Telephone Number	:	877-440-4263
Fax Number	:	405-600-1948

Provider Business Practice Location Address
First Line	:	5191 W CHARLESTON BLVD
Second Line	:	SUITE 190
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1449
Country	:	US
Telephone Number	:	702-896-7378
Fax Number	:	702-897-8252

Authorized Official
Title or Position	:	INSURANCE CONTRACTING SPECIALIST
Name	:	SHELLI MQ WALL
Credential	:
Telephone Number	:	405-600-1950

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	02/11/2009

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