Provider Demographics
NPI:1174611305
Name:ADVANCED DME SERVICES LLC
Entity type:Organization
Organization Name:ADVANCED DME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MARULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-949-2083
Mailing Address - Street 1:2 TIMBER LN
Mailing Address - Street 2:UNIT #302
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1482
Mailing Address - Country:US
Mailing Address - Phone:888-949-2083
Mailing Address - Fax:732-879-0384
Practice Address - Street 1:2 TIMBER LN
Practice Address - Street 2:UNIT #302
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1482
Practice Address - Country:US
Practice Address - Phone:888-949-2083
Practice Address - Fax:732-879-0384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5861710002Medicare NSC