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	31D0978203	OTHER		CLIA

General Provider Information

NPI Number	:	1720141351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 3001
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-0598
Country	:	US
Telephone Number	:	856-782-3300
Fax Number	:	856-504-8029

Provider Business Practice Location Address
First Line	:	740 MARNE HWY
Second Line	:	SUITE 206
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-3126
Country	:	US
Telephone Number	:	856-778-4009
Fax Number	:	856-778-4014

Authorized Official
Title or Position	:	CEO/CHAIRMAN
Name	:	DR. JOHN M TEDESCHI
Credential	:	M.D.
Telephone Number	:	856-782-3300

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	09/19/2014

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Directions to “ADVOCARE, LLC ” Practice Location

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