Provider Demographics
NPI: | 1447622303 |
---|---|
Name: | ADVOCARE, LLC |
Entity type: | Organization |
Organization Name: | ADVOCARE, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE VICE PRESIDENT AND COO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | CHUCK |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCQUEARY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 856-872-7055 |
Mailing Address - Street 1: | PO BOX 71422 |
Mailing Address - Street 2: | |
Mailing Address - City: | PHILADELPHIA |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19176-1422 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 856-872-7055 |
Mailing Address - Fax: | 856-504-8029 |
Practice Address - Street 1: | 1001 LAUREL OAK RD |
Practice Address - Street 2: | SUITE D1 |
Practice Address - City: | VOORHEES |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08043-3512 |
Practice Address - Country: | US |
Practice Address - Phone: | 856-248-0063 |
Practice Address - Fax: | 856-248-0067 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ADVOCARE , LLC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2015-10-30 |
Last Update Date: | 2022-09-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Single Specialty |