CMS-1500 Box 24J / 33a • NPI
1912304197
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3336C0003X (CMS 58)
Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy
Box 32 Service Location & ZIP+4
839 RICHLAND AVE W, AIKEN, SC, 29801-3833
✓ 9-Digit EDI 837 ZIP+4 (29801-3833)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1912304197 (ADVANCED MEDICAL GROUP, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1912304197 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVANCED MEDICAL GROUP, LLC |
| Plain-English Specialty | Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy NUCC Code: 3336C0003X (Pharmacy, Community/Retail Pharmacy) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 839 RICHLAND AVE W, AIKEN, SC, 29801-3833 |
| Practice Telephone / Fax | Tel: (803) 649-7437 | Fax: (803) 649-2062 |
| Administrative Mailing Address | PO BOX 1860, LANGLEY, SC, 29834-1860 |
| Enumeration & Last Sync | Enumerated: 2014-12-03 | CMS Record Updated: 2019-06-13 |
| Authorized Official | VANCE WALL (CEO / Owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (3336C0003X)
What Does Taxonomy Code 3336C0003X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3336C0003X translates to:
"Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVANCED MEDICAL GROUP, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
332B00000X — Durable Medical Equipment & Medical SuppliesPlain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies | State: N/A | License: Verified | Primary: Secondary |
333600000X — PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy | State: N/A | License: Verified | Primary: Secondary |
3336L0003X — Pharmacy, Long Term Care PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy, Long-term Care Pharmacy | State: N/A | License: Verified | Primary: Secondary |
3336C0003X — Pharmacy, Community/Retail PharmacyPlain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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