Provider Demographics
NPI:1427032291
Name:ADVOCATE MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:ADVOCATE MEDICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:RAWLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-895-7815
Mailing Address - Street 1:1055 WESTGATE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1451
Mailing Address - Country:US
Mailing Address - Phone:888-280-8632
Mailing Address - Fax:
Practice Address - Street 1:5912 BRECKENRIDGE PKWY STE G
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4200
Practice Address - Country:US
Practice Address - Phone:813-280-6543
Practice Address - Fax:877-426-7329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312723332B00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025792000Medicaid
GA572140235AMedicaid
CT1427032291Medicaid
KY7100119020Medicaid
AL009961215Medicaid
IA1427032291Medicaid
IN200492890 AMedicaid
LA2357336Medicaid
OH2502901Medicaid
NM8872554Medicaid
MN1427032291Medicaid
IL20708006001Medicaid
MI1427032291Medicaid
UT20708006001Medicaid
MI1730511965Medicaid
NC7705170Medicaid
FL001696900Medicaid
TN1513981Medicaid
OK200043720AMedicaid
RI3590001Medicaid
NC7704550Medicaid
AZ877946Medicaid
SCDE2783Medicaid
NM8872554Medicaid