Organization
ADVOCARE, LLC
Active
Parent organization
ADVOCARE , LLC
Other names
Advocare Aygen Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVOCARE , LLC
Authorized official
DEWAYNE HIEBERT (CHIEF, PAYOR RELATIONS AND POPULATI)
(856) 872-7055
Entity
Organization
Contact information
Practice address
530 E MAIN ST, STE 4A, CHESTER, NJ 07930-2669
(908) 879-4300
(908) 879-8956
Mailing address
401 ROUTE 73 N STE 320, MARLTON, NJ 08053-3426
(856) 872-7055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31D0116586
CLIA
—
Enumeration date
08/03/2009
Last updated
05/02/2022
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