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General NPI Number Information
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NPI Number | 1861466179
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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 | 02/14/2006
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 1005 W H SMITH BLVD
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City | GREENVILLE
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State | NC
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Zip | 27834-5052
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Country | US
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Telephone | 252-353-6800
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Fax | 252-355-0446
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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 | 800-311-7783
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MIKE 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 | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 07726
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 00552
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 00552
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License Number State | NC
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