Healthcare Provider Details

I. General information

NPI: 1639514151
Provider Name (Legal Business Name): ADVANCED NURSING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2013
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 CUTHBERT ST FL 4B
PHILADELPHIA PA
19106-4552
US

IV. Provider business mailing address

219 CUTHBERT ST FL 4B
PHILADELPHIA PA
19106-4552
US

V. Phone/Fax

Practice location:
  • Phone: 610-696-5045
  • Fax: 267-534-4113
Mailing address:
  • Phone: 610-696-5045
  • Fax: 267-534-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04970501
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number04970501
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number04970501
License Number StatePA

VIII. Authorized Official

Name: JOHN KUNGU
Title or Position: CEO
Credential:
Phone: 610-696-5045