Organization Name: | DME ADVANTA, LLC. |
NPI Number: | 1053645101 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREGORY JOHN SIMMS (PRESIDENT) |
Mailing Address: | 4815 E Carefree Hwy Suite 108 Cave Creek |
State: | AZ US |
Postal Code: | 853314717 |
Phone Number: | 4805756521 |
Fax Number: | 4805223939 |
NPI Enumeration Date: | 09/22/2009 |
NPI Last Update Date: | 09/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 20162822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |