Provider Demographics
NPI:1174767206
Name:ADVANCED INDOOR SOLUTIONS INC.
Entity type:Organization
Organization Name:ADVANCED INDOOR SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KORI
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-255-2606
Mailing Address - Street 1:3434 SARATOGA AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0744
Mailing Address - Country:US
Mailing Address - Phone:701-255-2606
Mailing Address - Fax:888-955-2606
Practice Address - Street 1:3434 SARATOGA AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0744
Practice Address - Country:US
Practice Address - Phone:701-255-2606
Practice Address - Fax:888-955-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies