1902045297 NPI number — ADVANCED MEDICAL ENTERPRISES LP

Table of content: (NPI 1902045297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902045297 NPI number — ADVANCED MEDICAL ENTERPRISES LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED MEDICAL ENTERPRISES LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902045297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5765
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMOND
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73083-5765
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-440-4263
Provider Business Mailing Address Fax Number:
405-600-1948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5191 W CHARLESTON BLVD
Provider Second Line Business Practice Location Address:
SUITE 190
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89146-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-896-7378
Provider Business Practice Location Address Fax Number:
702-897-8252
Provider Enumeration Date:
02/11/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALL
Authorized Official First Name:
SHELLI
Authorized Official Middle Name:
MQ
Authorized Official Title or Position:
INSURANCE CONTRACTING SPECIALIST
Authorized Official Telephone Number:
405-600-1950

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)