Provider Demographics
NPI:1831801539
Name:ADVANCED HOME MEDICAL LLC
Entity type:Organization
Organization Name:ADVANCED HOME MEDICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-818-5258
Mailing Address - Street 1:6414 S 118TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3576
Mailing Address - Country:US
Mailing Address - Phone:402-933-6412
Mailing Address - Fax:402-281-4490
Practice Address - Street 1:8320 YANKEE ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1808
Practice Address - Country:US
Practice Address - Phone:937-759-8710
Practice Address - Fax:937-759-8711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED HOME MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-14
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies