Healthcare Provider Details
I. General information
NPI: 1104182021
Provider Name (Legal Business Name): ADVOCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2012
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 E EVESHAM RD BLDG 800 SUITE 122
VOORHEES NJ
08043-4501
US
IV. Provider business mailing address
PO BOX 71422
PHILADELPHIA PA
19176-1422
US
V. Phone/Fax
- Phone: 856-770-9300
- Fax: 856-770-8238
- Phone: 856-872-7055
- Fax: 856-504-8029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
M
TEDESCHI
Title or Position: CEO/CHAIRMAN
Credential: MD
Phone: 856-782-3300