Basic Information
| Provider Information | |||||||||
| NPI: | 1134642994 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVOCARE , LLC | ||||||||
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| OtherOrganizationName: | ADVOCARE ARTHRITIS, OSTEOPOROSIS & RHEUMOTOLOGY ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 71422 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191761422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568727055 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1051 W SHERMAN AVE STE C1B | ||||||||
| Address2: | |||||||||
| City: | VINELAND | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083606931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564574490 | ||||||||
| FaxNumber: | 8564574489 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2017 | ||||||||
| LastUpdateDate: | 05/31/2022 | ||||||||
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| AuthorizedOfficialLastName: | CANDIA | ||||||||
| AuthorizedOfficialFirstName: | DAWN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 8568727053 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ADVOCARE , LLC | ||||||||
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| NPICertificationDate: | 05/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.