Organization
ADVANCED MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA F WELLS (PRESIDENT)
(614) 870-0111
Entity
Organization
Contact information
Practice address
4840 W BROAD ST, COLUMBUS, OH 43228-1602
(614) 870-0111
(614) 870-9114
Mailing address
4840 W BROAD ST, COLUMBUS, OH 43228-1602
(614) 870-0111
(614) 870-9114
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OH
335E00000X
Prosthetic/Orthotic Supplier
18
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155125
ANTHEM
OH
05
—
0737475
—
OH
01
—
0975476
AETNA
OH
Enumeration date
05/24/2005
Last updated
03/13/2019
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