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General NPI Number Information
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NPI Number | 1396297321
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL CARE CENTER
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 901 ROUTE 73 N SUITE C
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City | MARLTON
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State | NJ
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Zip | 08053-1226
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Country | US
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Telephone | 856-581-9711
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Fax |
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Provider Business Mailing Address
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Address Line | 901 ROUTE 73 N SUITE C
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City | MARLTON
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State | NJ
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Zip | 08053-1226
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALFRED TAWADROUS
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Credential |
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Telephone | 856-581-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 25MA07842400
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License Number State | NJ
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