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General NPI Number Information
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NPI Number | 1770856460
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Entity Type | Organization
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Legal Business Name | ADVANCED HOME CARE, INC
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Dates
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Enumeration Date | 02/11/2012
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 7669 LIMESTONE DR SUITE 120
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City | GAINESVILLE
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State | VA
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Zip | 20155-4037
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Country | US
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Telephone | 703-656-2063
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Fax | 800-311-7783
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Provider Business Mailing Address
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Address Line | PO BOX 18049
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City | GREENSBORO
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State | NC
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Zip | 27419-8049
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Country | US
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Telephone | 336-878-8950
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Fax | 336-878-8883
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MICHAEL KALBAUGH
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Credential |
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Telephone | 336-878-8824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | TO BE ISSUED
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License Number State | VA
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