Advanced Medical Group, LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Suwanee, GA
NPI 1003087685 · NPPES record last updated Jun 24, 2016
Key facts
- NPI
- 1003087685
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- ADVANCED MEDICAL GROUP, LLC
- Practice address
- 450 Old Peachtree Rd NW
Suite 102
Suwanee, GA 30024-7289 - Phone
- (877) 645-3506
- Fax
- (888) 273-1488
- NPI assigned
- Mar 21, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Vance Timothy Wall, RPH
- Title
- Ceo
- Phone
- (678) 985-7246
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Langley Drug Company
Locations
450 Old Peachtree Rd NW
Ste 102
Suwanee, GA 30024
Phone (877) 645-3506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X | 9181 | SC |
Addresses
Primary practice location
450 Old Peachtree Rd NW
Suite 102
Suwanee, GA 30024-7289
Mailing address
PO Box 1860
Langley, SC 29834-1860
Phone (803) 593-3411
Other providers in Suwanee, GA
- Advance Care Medical Georgia, Inc.
- Advance Care Medical PCP Georgia, Inc.
- Advance Laparoscopic Surgery Institute, Inc.
- Advanced Family Eyecare
- Advanced Gastroenterology Associates, LLC
- Aegis Group Practice LLC
- Affinity Choice LLC
- Agape Family Medicine, P.C.
- Komal Agarwal
- Hibbah Ailya Agha
All providers in Suwanee, GA · Durable Medical Equipment & Medical Supplies in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.