Organization
ADVANTAGE DIABETIC AND MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE S WEAVER (PRESIDENT)
(251) 661-2238
Entity
Organization
Contact information
Practice address
107 N FLORIDA ST, MOBILE, AL 36607-3009
(251) 661-2238
(251) 661-2177
Mailing address
107 N FLORIDA ST, MOBILE, AL 36607-3009
(251) 661-2238
(251) 661-2177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
595
AL
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009973425
—
AL
01
—
51524260
BCBS PROVIDER ID
AL
Enumeration date
07/25/2006
Last updated
03/20/2012
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