Provider Demographics
NPI:1568270155
Name:ADVANCED MEDICAL SUPPLY
Entity type:Organization
Organization Name:ADVANCED MEDICAL SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHEYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-559-6658
Mailing Address - Street 1:99 WALL ST # 4139
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-4301
Mailing Address - Country:US
Mailing Address - Phone:646-559-6658
Mailing Address - Fax:
Practice Address - Street 1:FIVE GREENTREE CENTRE 525 ROUTE 73 NORTH STE 104
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:646-269-0989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies