MEDICARE: ADVOCARE, 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
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1326050394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCARE, LLC

Provider Business Mailing Address
First Line	:	401 ROUTE 73 N STE 320
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-3426
Country	:	US
Telephone Number	:	856-872-7055
Fax Number	:	856-504-8029

Provider Business Practice Location Address
First Line	:	701 MONTGOMERY AVE
Second Line	:	SUITE 18
City	:	PENN VALLEY
State	:	PA
Zip	:	19072-2036
Country	:	US
Telephone Number	:	610-642-9200
Fax Number	:	610-649-4723

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT AND COO
Name	:	CHARLES MCQUEARY
Credential	:
Telephone Number	:	856-872-7055

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	11/22/2021

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