MEDICARE: ADVANCED HOME CARE, INC.

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	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1295047249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HOME CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 18049
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27419-8049
Country	:	US
Telephone Number	:	336-878-8950
Fax Number	:	800-311-7783

Provider Business Practice Location Address
First Line	:	2424 INDIA HOOK RD STE 130
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1278
Country	:	US
Telephone Number	:	803-285-2026
Fax Number	:	800-311-7783

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MIKE KALBAUGH
Credential	:
Telephone Number	:	336-878-8824

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	10/17/2018

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