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	:	1336432244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 71422
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19176-1422
Country	:	US
Telephone Number	:	856-872-7055
Fax Number	:	856-504-8029

Provider Business Practice Location Address
First Line	:	1050 MANTUA PIKE
Second Line	:	SUITE 200
City	:	WENONAH
State	:	NJ
Zip	:	08090-1141
Country	:	US
Telephone Number	:	856-853-0848
Fax Number	:	856-853-1889

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	DAWN M CANDIA
Credential	:
Telephone Number	:	856-872-7053

Provider Enumeration Date	:	05/25/2011
Last Update Date	:	10/27/2021

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