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Organization
ADVANCED MEDICAL GROUP, LLC
Active
Organization
ADVANCED MEDICAL GROUP, LLC
Active
Other names
Medicine Mart
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VANCE T WALL R.PH (CEO / OWNER)
(678) 985-7246
Entity
Organization
Contact information
Practice address
839 RICHLAND AVE W, AIKEN, SC 29801-3833
(803) 649-7437
(803) 649-2062
Mailing address
PO BOX 1860, LANGLEY, SC 29834-1860
(803) 593-3411
(888) 273-1488
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Enumeration date
12/03/2014
Last updated
06/13/2019
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