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Contact Information

ADVANCED HOME MED, LLC
5624 N GOVERNMENT WAY
STE 6
DALTON GARDENS, ID83815-7350
 Phone: 208-772-9111
 Fax: 208-772-9114
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for ADVANCED HOME MED, LLC

NPI # 1992734859
LBN Legal business name ADVANCED HOME MED, LLC
Authorized official KAMI DAVIS - (PARTNER OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/02/2006
Last updated 03/02/2010 - About 16 years ago
Identifiers
ID License # DME166
ID Medicaid 806024600
NV Medicaid 100502494
WA Medicaid 9054859
ID Other CC8203 BCBS OF ID
ID Other 8I227 BLUE CROSS OF ID
ID Other 000010137820 REGENCE BS OF ID
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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