Organization
ADVANCED TISSUE, LLC
Active
Parent organization
AT BUYER, INC.
Other names
Advanced Tissue
Organization subpart
Yes
Provider details
NPI number
Legal business name
AT BUYER, INC.
Authorized official
MR. DOUGLAS KEVIN LAMB (CHIEF EXECUTIVE OFFICER)
(501) 217-9900
Entity
Organization
Contact information
Practice address
7003 VALLEY RANCH DR, LITTLE ROCK, AR 72223-4696
(501) 217-9900
(501) 217-9939
Mailing address
7003 VALLEY RANCH DR, LITTLE ROCK, AR 72223-4696
(501) 217-9900
(501) 217-9939
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000979536A
—
GA
05
—
0031177
—
CT
05
—
009966110
—
AL
05
—
0440992
—
MS
05
—
0563775
—
IA
05
—
1000037816
—
DE
05
—
1153184
—
LA
05
—
143955716
—
AR
05
—
200446340A
—
IN
05
—
34637036
—
CO
05
—
401946600
—
MD
05
—
431825000
—
ME
05
—
733982
—
AZ
05
—
806569500
—
ID
05
—
874487746
—
MI
05
—
90003740
—
KY
05
—
984669700
—
MN
05
—
MS151AR
—
AK
Enumeration date
08/16/2006
Last updated
10/02/2015
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