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Organization

ADVANCED HOME CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE KALBAUGH (CREDENTIALING SPECIALIST)
(336) 878-8824
Entity
Organization

Contact information

Practice address
2520 WHITEHALL PARK DR, SUITE 950, CHARLOTTE, NC 28273-3557
(704) 831-5000
(877) 242-3291
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(336) 878-8950
(336) 878-8896

Taxonomy

Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
07151
NC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00355
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
00355
NC
332BX2000X
Oxygen Equipment & Supplies (DME)
00355
NC
333600000X
Pharmacy
07151
NC
3336H0001X
Home Infusion Therapy Pharmacy
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0486P
BCBSNC DME
NC
01
0494A
BCBSNC IV
NC
05
0609016
NC
01
1013981
UHC ACM
NC
01
3429669
NCPDP
NC
05
6800431
NC
05
7702486
NC
05
7N5113
SC
01
8295
PARTNERS
NC
05
DE7291
SC
Enumeration date
01/19/2006
Last updated
11/21/2017
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