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General NPI Number Information
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NPI Number | 1053737197
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Entity Type | Organization
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Legal Business Name | ADVOCARE, LLC
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 06/30/2019
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Provider Practice Location Address
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Address Line | 1000 WHITE HORSE RD SUITE 106
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City | VOORHEES
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State | NJ
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Zip | 08043-4406
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Country | US
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Telephone | 856-772-9090
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Fax | 856-772-1460
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Provider Business Mailing Address
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Address Line | 401 ROUTE 73 N STE 320
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City | MARLTON
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State | NJ
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Zip | 08053-3426
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Country | US
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Telephone | 856-872-7055
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Fax |
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Authorized Official
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Title or Position | EXECTIVE VP AND COO
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Name | CHARLES MCQUEARY
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Credential |
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Telephone | 856-872-7055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA05161100
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License Number State | NJ
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