Healthcare Provider Details

I. General information

NPI: 1881035699
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 LAFAYETTE RD SUITE D
SPARTA NJ
07871-3497
US

IV. Provider business mailing address

PO BOX 71422
PHILADELPHIA PA
19176-1422
US

V. Phone/Fax

Practice location:
  • Phone: 973-300-1553
  • Fax: 973-383-5113
Mailing address:
  • Phone: 856-872-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES MCQUEARY
Title or Position: CEO
Credential:
Phone: 856-872-7055