Organization
ADVOCARE , LLC
Active
Parent organization
ADVOCARE , LLC
Other names
Advocare Heritage Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVOCARE , LLC
Authorized official
CHARLES MCQUEARY (EXECUTIVE VICE PRESIDENT AND COO)
(856) 872-7055
Entity
Organization
Contact information
Practice address
703 E MAIN ST, SUITE 9, MOORESTOWN, NJ 08057-3082
(856) 235-0290
(856) 795-1213
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
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0153851
—
NJ
01
—
31D0118841
CLIA
NJ
01
—
31D0118841
CLIA
—
Enumeration date
02/18/2008
Last updated
06/28/2019
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