Healthcare Provider Details

I. General information

NPI: 1841370913
Provider Name (Legal Business Name): ADVANCED HEALTHCARE, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12901 W NATIONAL AVE
NEW BERLIN WI
53151-4063
US

IV. Provider business mailing address

3003 W GOOD HOPE RD
MILWAUKEE WI
53209-2042
US

V. Phone/Fax

Practice location:
  • Phone: 262-782-7770
  • Fax:
Mailing address:
  • Phone: 414-352-3100
  • Fax: 414-247-4590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EUGENE W. MONROE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 414-352-3100