1770538696 NPI number — ADVOCARE, LLC

Table of content: (NPI 1770538696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770538696 NPI number — ADVOCARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CHILDREN'S HEALTH ASSOCIATES, LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770538696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 ROUTE 73 N STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARLTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08053-3426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-872-7055
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 ROUTE 73 N STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARLTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08053-3426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-872-7055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CANDIA
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR OF CREDENTIALING
Authorized Official Telephone Number:
856-872-7053

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2080P0008X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 31D0115336 . This is a "ADVOCARE MEDICAL CENTER AT BUDD LAKE- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0118770 . This is a "ADVOCARE THE FARM PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0119922 . This is a "ADVOCARE SOUTH JERSEY PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D1073248 . This is a "ADVOCARE KRESSVILLE PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D1087657 . This is a "ADVOCARE ATRIUM PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D1105569 . This is a "ADVOCARE MEDFORD PEDIATRIC AND ADOLESCENT MEDICINE- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0691840 . This is a "ADVOCARE PEDIATRIC PHYSICIANS OF BURLINGTON COUNTY- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0698283 . This is a "ADVOCARE MARLTON PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0707941 . This is a "ADVOCARE MERCHANTVILLE PEDIATRIC ASSOCIATION- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0911582 . This is a "ADVOCARE GROVE FAMILY MEDICAL ASSOCIATES- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0996061 . This is a "ADVOCARE PRIMARY CARE FOR ADULTS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0117249 . This is a "ADVOCARE SOUTH JERSEY PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D2004042 . This is a "ADVOCARE DELGIORNO ENDOCRINOLOGY- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 39D0203503 . This is a "ADVOCARE BROOMALL PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: MULTIPLE MEDICAID . This is a "24 GROUPS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 31D0118892 . This is a "ADVOCARE MOORESTOWN FAMILY PRACTICE- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0119875 . This is a "ADVOCARE CORNERSTONE PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0676726 . This is a "ADVOCARE GARDEN STATE PEDIATRIC AND ADOLESCENT MEDICINE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D0881246 . This is a "ADVOCARE DELRAN PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31D1028404 . This is a "ADVOCARE TOWNSHIP PEDIATRICS- CLIA" identifier . This identifiers is of the category "OTHER".




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