Provider Demographics
NPI:1962417436
Name:ADVANCED MEDICAL HOMECARE SUPPLIES, LLC.
Entity type:Organization
Organization Name:ADVANCED MEDICAL HOMECARE SUPPLIES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-524-1510
Mailing Address - Street 1:1155 PHOENIXVILLE PIKE STE 114
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4285
Mailing Address - Country:US
Mailing Address - Phone:610-524-1510
Mailing Address - Fax:610-524-2123
Practice Address - Street 1:1155 PHOENIXVILLE PIKE STE 114
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4285
Practice Address - Country:US
Practice Address - Phone:610-524-1510
Practice Address - Fax:610-524-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006665332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014824800001Medicaid
PA1014824800001Medicaid
DE5477970001Medicare NSC
PA5477970001Medicare NSC
MD5477970001Medicare NSC