MEDICARE: ADVANCE INCARE SUPPLY GROUP, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1922288042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE INCARE SUPPLY GROUP, INC.

Provider Business Mailing Address
First Line	:	551 E 49TH ST
Second Line	:	SUITE 11
City	:	HIALEAH
State	:	FL
Zip	:	33013-1904
Country	:	US
Telephone Number	:	305-953-2997
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 E 49TH ST
Second Line	:	SUITE 11
City	:	HIALEAH
State	:	FL
Zip	:	33013-1904
Country	:	US
Telephone Number	:	305-696-5315
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOAQUIN M FERRERO
Credential	:
Telephone Number	:	305-953-2997

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	03/19/2009

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