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General NPI Number Information
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NPI Number | 1407492127
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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 | 11/19/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 250 W LANCASTER AVE STE 200
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City | PAOLI
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State | PA
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Zip | 19301-1751
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Country | US
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Telephone | 610-889-7530
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Fax |
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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 |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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