Advance Mobile Dialysis Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

10812630#5PK73 Issued in LA

Legal business name

ADVANCE MOBILE DIALYSIS INC.

Practice address

2054 Bermuda St
Shreveport, LA 71105-3802

Phone

(318) 349-1826

NPI assigned

Apr 4, 2017

Last updated

Apr 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Don Arnett Cook Jr., RT

Title

Owner/President

Phone

(318) 423-0159

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1740713148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 BERMUDA ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053802",
            "telephone_number": "318-349-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 BERMUDA ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053802",
            "telephone_number": "318-349-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MOBILE DIALYSIS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "ARNETT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "318-423-0159",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "10812630#5PK73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Home Health Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.