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
744 CHURCH ST N, CONCORD, NC 28025-4336
(704) 784-2110
(704) 795-6495
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(336) 878-8950
(336) 878-8896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
TO BE ISSUED
NC
332BC3200X
Customized Equipment (DME)
TO BE ISSUED
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
TO BE ISSUED
NC
332BX2000X
Oxygen Equipment & Supplies (DME)
TO BE ISSUED
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0486P
BCBSNC DME
NC
01
—
0494A
BCBSNC IV
NC
01
—
1013981
UHC ACM
NC
01
—
8295
PARTNERS
NC
Enumeration date
10/19/2006
Last updated
11/21/2017
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