Advance Group L.L.C.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

R2173 Issued in MD

Legal business name

ADVANCE GROUP L.L.C.

Practice address

1328 Reisterstown Rd
Ste C
Pikesville, MD 21208-3838

Phone

(410) 580-2040

Fax

(410) 580-2060

NPI assigned

Jun 1, 2005

Organization subpart

No

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

Authorized official

Name

Yeduard Pastushenko

Title

President

Phone

(410) 580-2040

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Advance Group Medical Supply & Equipment Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1699777979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 REISTERSTOWN RD",
            "address_2": "STE C",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083838",
            "telephone_number": "410-580-2040",
            "fax_number": "410-580-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 REISTERSTOWN RD",
            "address_2": "STE C",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083838",
            "telephone_number": "410-580-2040",
            "fax_number": "410-580-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE GROUP L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PASTUSHENKO",
        "authorized_official_first_name": "YEDUARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-580-2040"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "R2173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000039562",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383603700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406372400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383602900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance Group Medical Supply & Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Durable Medical Equipment & Medical Supplies in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.