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NPI Code Detail

MEDICARE: ADVANCED CARE CENTER, LLC

MEDICARE: ADVANCED CARE CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist01060297IN
2174400000XSpecialist01044433IN
3174400000XSpecialist34216TN

General Provider Information

NPI Number : 1144348509
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED CARE CENTER, LLC
Provider Business Mailing Address
First Line : 703 GREEN RD
Second Line : SUITE #1
City : MADISON
State : IN
Zip : 47250-2145
Country : US
Telephone Number : 812-265-9900
Fax Number : 812-265-9998
Provider Business Practice Location Address
First Line : 2001 CHARLOTTE AVE
Second Line : SUITE205
City : NASHVILLE
State : TN
Zip : 37203-2032
Country : US
Telephone Number : 812-265-9900
Fax Number : 812-265-9998
Authorized Official
Title or Position : PRESIDENT
Name : DR. EDWARD P EBERTH
Credential : MD
Telephone Number : 812-265-9900
Provider Enumeration Date : 03/26/2007
Last Update Date : 04/20/2008

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Directions to “ADVANCED CARE CENTER, LLC ” Practice Location

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