Organization
ADVANCED MEDICAL, LLC
Active
Organization
ADVANCED MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG KANIECKI (EVP, GROWTH & OPERATIONS)
(769) 233-8484
Entity
Organization
Contact information
Practice address
625 S PEAR ORCHARD RD STE A, RIDGELAND, MS 39157-4836
(769) 233-8484
Mailing address
625 S PEAR ORCHARD RD STE A, RIDGELAND, MS 39157-4811
(769) 233-8484
(769) 233-8051
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07126704
—
MS
Enumeration date
11/17/2006
Last updated
07/17/2026
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