Healthcare Provider Details

I. General information

NPI: 1386096030
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 ORIENT WAY
RUTHERFORD NJ
07070-2052
US

IV. Provider business mailing address

PO BOX 3001
VOORHEES NJ
08043-0598
US

V. Phone/Fax

Practice location:
  • Phone: 201-964-0200
  • Fax: 201-964-0220
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-762-1751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHUCK MCQUEARY
Title or Position: PRESIDENT
Credential:
Phone: 856-504-8028