MEDICARE: ADVOCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	31D0911582	OTHER		CLIA

General Provider Information

NPI Number	:	1033164850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCARE, LLC

Provider Business Mailing Address
First Line	:	401 ROUTE 73 N STE 320
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-3426
Country	:	US
Telephone Number	:	856-872-7055
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 GROVE ST
Second Line	:	SUITE A
City	:	HADDONFIELD
State	:	NJ
Zip	:	08033-1224
Country	:	US
Telephone Number	:	856-354-2211
Fax Number	:	856-354-6181

Authorized Official
Title or Position	:	EXECUTIVE VP AND COO
Name	:	CHARLES MCQUEARY
Credential	:
Telephone Number	:	856-872-7055

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	04/06/2021

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Directions to “ADVOCARE, LLC ” Practice Location

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