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)	07726	NC
2	332BX2000X	Oxygen Equipment & Supplies (DME)	00552	NC
3	332B00000X	Durable Medical Equipment & Medical Supplies	00552	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0486P	OTHER	NC	BCBSNC DME
2	0494A	OTHER	NC	BCBSNC IV
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8295	OTHER	NC	PARTNERS
5	1013981	OTHER	NC	UHC ACM

General Provider Information

NPI Number	:	1861466179
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	:	1005 W H SMITH BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5052
Country	:	US
Telephone Number	:	252-353-6800
Fax Number	:	252-355-0446

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	10/09/2017

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

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