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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	HC0454	NC
2	332BX2000X	Oxygen Equipment & Supplies (DME)	00785	NC
3	332B00000X	Durable Medical Equipment & Medical Supplies	00785	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0486P	OTHER	NC	BCBSNC DME
2	8295	OTHER	NC	PARTNERS
3	0494A	OTHER	NC	BCBSNC IV
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568436657
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	:	336-878-8853

Provider Business Practice Location Address
First Line	:	1806 N SANDHILLS BLVD
Second Line	:
City	:	ABERDEEN
State	:	NC
Zip	:	28315-2336
Country	:	US
Telephone Number	:	910-295-4119
Fax Number	:	800-311-7783

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	06/06/2017

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Directions to “ADVANCED HOME CARE, INC. ” Practice Location

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