# ADVANCED MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medicine Mart
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912304197
- **Authorized official:** MR. VANCE T WALL R.PH (CEO / OWNER)
- **Authorized official phone:** (678) 985-7246

## Contact information

- **Practice address:** 839 RICHLAND AVE W, AIKEN, SC 29801-3833
- **Practice address phone:** (803) 649-7437
- **Practice address fax:** (803) 649-2062
- **Mailing address:** PO BOX 1860, LANGLEY, SC 29834-1860
- **Mailing address phone:** (803) 593-3411
- **Mailing address fax:** (888) 273-1488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/03/2014
- **Last updated:** 06/13/2019