Healthcare Provider Details
I. General information
NPI: 1225071038
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2006
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
183 ROUTE 206 1
FLANDERS NJ
07836-9261
US
IV. Provider business mailing address
PO BOX 71422
PHILADELPHIA PA
19176-1422
US
V. Phone/Fax
- Phone: 973-347-3277
- Fax: 973-347-3141
- Phone: 856-872-7055
- Fax: 856-504-8029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLES
MCQUEARY
Title or Position: EXECUTIVE VP AND COO
Credential:
Phone: 856-872-7055