MEDICARE: ADVANTAGE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1891534723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANTAGE HOME CARE INC.

Provider Business Mailing Address
First Line	:	8725 ALAMEDA PARK DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-2475
Country	:	US
Telephone Number	:	505-828-0232
Fax Number	:

Provider Business Practice Location Address
First Line	:	8725 ALAMEDA PARK DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-2475
Country	:	US
Telephone Number	:	505-828-0232
Fax Number	:

Authorized Official
Title or Position	:	CIO
Name	:	REYNOLD BUNZEL
Credential	:
Telephone Number	:	505-379-9841

Provider Enumeration Date	:	05/21/2024
Last Update Date	:	05/21/2024

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