1962581637 NPI number — ADVANZED HEALTH CARE, PLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962581637 NPI number — ADVANZED HEALTH CARE, PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANZED HEALTH CARE, PLC
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:
Provider Other Organization Name Type Code:
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:
1962581637
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1715 N GEORGE MASON DR
Provider Second Line Business Mailing Address:
#306
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22205-3609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-276-0630
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1715 N GEORGE MASON DR
Provider Second Line Business Practice Location Address:
#306
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22205-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-276-0630
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AMEDEO
Authorized Official First Name:
RALPH
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
703-276-0630

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6496 . This is a "CAREFIRST ID" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1558369991 . This is a "AMEDEO NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1386643385 . This is a "DR DREGER NPI #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5846358 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1962581637 . This is a "ADVANZED HEALTH CARE NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5874319 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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