Healthcare Provider Details

I. General information

NPI: 1508167412
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 E MAIN ST
MARLTON NJ
08053-2141
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 856-988-0570
  • Fax: 856-988-0303
Mailing address:
  • Phone: 856-872-7055
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DEWAYNE HIEBERT
Title or Position: CHIEF PAYER RELATIONS
Credential:
Phone: 856-872-7055