Provider Demographics
NPI:1386705416
Name:ADVANCED MEDICAL SOULTIONS PHARMACY
Entity type:Organization
Organization Name:ADVANCED MEDICAL SOULTIONS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SARRANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:770-781-2095
Mailing Address - Street 1:655 ATLANTA RD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2785
Mailing Address - Country:US
Mailing Address - Phone:770-781-2095
Mailing Address - Fax:770-781-2096
Practice Address - Street 1:655 ATLANTA RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2785
Practice Address - Country:US
Practice Address - Phone:770-781-2095
Practice Address - Fax:770-781-2096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BX2000X
GAPHRE0089703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy