Healthcare Provider Details

I. General information

NPI: 1104269950
Provider Name (Legal Business Name): ADVOCARE , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N FINLEY AVE
BASKING RIDGE NJ
07920-1686
US

IV. Provider business mailing address

401 ROUTE 73 N STE 320
MARLTON NJ
08053-3426
US

V. Phone/Fax

Practice location:
  • Phone: 908-766-4660
  • Fax: 908-204-9871
Mailing address:
  • Phone: 856-872-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES MCQUEARY
Title or Position: EXECUTIVE VP AND COO
Credential:
Phone: 856-872-7055