NPIMap

Organization Active NPI

Advantage Medical Supply, Inc.

Doing business as Advantage Home Medical, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Page, AZ
National Provider Identifier
1689392847
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
ADVANTAGE MEDICAL SUPPLY, INC.
Doing business as
Advantage Home Medical, Inc.
Practice address
667 S Lake Powell Blvd
Page, AZ 86040-0858
Phone
(928) 660-0536
Fax
(888) 270-0202
NPI assigned
Aug 15, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANTAGE MEDICAL SUPPLY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kory S Young
Title
VP
Phone
(801) 807-9395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

667 S Lake Powell Blvd
Page, AZ 86040-0858

Mailing address

670 S Highway 89a
Kanab, UT 84741-3680
Phone (435) 644-8600

Other names 1

  • Advantage Home Medical, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230124001900 AZ DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 0941320683 Practice locations: Page, AZ

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Advantage Home Medical Equipment667 S Lake Powell Blvd, Page, AZ 86040-0858(928) 660-0536 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Hospital Beds (Electric)|Hospital Beds (Manual)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Traction Equipment|Ultraviolet Light Devices and/or Supplies|Canes and/or Crutches|Patient Lifts|Power Operated Vehicles (Scooters)|S… Does not accept assignmentParticipating since Jan 1, 2009

National Provider Directory

National Provider Directory
Tax ID family
Advantage Medical Supply Inc8 organizations share this tax ID, including this one
Part of
Advantage Medical Supply Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

670 S Highway 89A
Kanab, UT 84741
Phone (435) 644-8600

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1689392847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 S HIGHWAY 89A",
            "city": "KANAB",
            "state": "UT",
            "postal_code": "847413680",
            "telephone_number": "435-644-8600",
            "fax_number": "435-644-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 S LAKE POWELL BLVD",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860400858",
            "telephone_number": "928-660-0536",
            "fax_number": "888-270-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE MEDICAL SUPPLY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANTAGE MEDICAL SUPPLY, INC.",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KORY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "801-807-9395"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Home Medical, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Page, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.