Healthcare Provider Details
I. General information
NPI: 1750399762
Provider Name (Legal Business Name): ADVANCED HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2006
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
302 BAY ST
GADSDEN AL
35901
US
IV. Provider business mailing address
PO BOX 27
GADSDEN AL
35902
US
V. Phone/Fax
- Phone: 256-549-0630
- Fax: 256-549-0633
- Phone: 256-549-0630
- Fax: 256-549-0633
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | AL |
VIII. Authorized Official
Name: MRS.
JUDY
K
CAMPBELL
Title or Position: CEO
Credential: PRESIDENT
Phone: 256-549-0630