Organization
AVENIR MEDICAL SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMAL ANDREW REVOLUS (OWNER)
(973) 580-1372
Entity
Organization
Contact information
Practice address
102 THACHER LN, SOUTH ORANGE, NJ 07079-2463
(973) 580-1372
Mailing address
102 THACHER LN, SOUTH ORANGE, NJ 07079-2463
(973) 580-1372
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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