Provider Demographics
NPI:1104447697
Name:ACCESSIBILITY ADVANTAGE LLC
Entity type:Organization
Organization Name:ACCESSIBILITY ADVANTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAILLOUX
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:570-650-1111
Mailing Address - Street 1:1335 HIGHWAY 315
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILKES-BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7007
Mailing Address - Country:US
Mailing Address - Phone:570-445-9214
Mailing Address - Fax:570-550-9907
Practice Address - Street 1:1335 HIGHWAY 315
Practice Address - Street 2:SUITE 2
Practice Address - City:WILKES-BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7007
Practice Address - Country:US
Practice Address - Phone:570-445-9214
Practice Address - Fax:570-550-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies