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General NPI Number Information
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NPI Number | 1457676421
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Entity Type | Organization
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Legal Business Name | ADVOCACY MEDICINE, LLC
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Dates
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Enumeration Date | 04/02/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 128 HEALTH CARE LN
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City | MARTINSBURG
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State | WV
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Zip | 25401-4009
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Country | US
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Telephone | 336-253-2566
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Fax | 304-596-0381
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Provider Business Mailing Address
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Address Line | 128 HEALTH CARE LN
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City | MARTINSBURG
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State | WV
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Zip | 25401-4009
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Country | US
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Telephone | 336-253-2566
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Fax | 304-596-0381
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Authorized Official
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Title or Position | PRES/CEO
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Name | DR. LEO BACHI EYOMBO
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Credential | O.D.,ED.D.,MBA
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Telephone | 336-253-2566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | APPLIED FOR
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | WV
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