Organization
ADVANCE GROUP L.L.C.
Active
Other names
Advance Group Medical Supply & Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
YEDUARD PASTUSHENKO (PRESIDENT)
(410) 580-2040
Entity
Organization
Contact information
Practice address
1328 REISTERSTOWN RD, STE C, PIKESVILLE, MD 21208-3838
(410) 580-2040
(410) 580-2060
Mailing address
1328 REISTERSTOWN RD, STE C, PIKESVILLE, MD 21208-3838
(410) 580-2040
(410) 580-2060
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
R2173
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000039562
—
DE
05
—
383602900
—
MD
05
—
383603700
—
MD
05
—
406372400
—
MD
Enumeration date
06/01/2005
Last updated
04/20/2008
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