Organization
ADVANCED MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VANCE TIMOTHY WALL RPH (CEO)
(678) 985-7246
Entity
Organization
Contact information
Practice address
450 OLD PEACHTREE RD NW, SUITE 102, SUWANEE, GA 30024-7289
(877) 645-3506
(888) 273-1488
Mailing address
PO BOX 1860, LANGLEY, SC 29834-1860
(803) 593-3411
(678) 689-1459
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3336C0003X
Community/Retail Pharmacy
9181
SC
Other
Enumeration date
03/21/2008
Last updated
06/24/2016
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