Organization
ADVOCARE, LLC
Active
Parent organization
ADVOCARE , LLC
Other names
Advocare Pediatric Medical Associates
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
420 W TOWNSHIP LINE RD, HAVERTOWN, PA 19083-5210
(610) 449-6200
(610) 449-0775
Mailing address
401 ROUTE 73 N STE 320, MARLTON, NJ 08053-3426
(856) 872-7055
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021601A
CLIA
—
05
—
101628997
—
PA
Enumeration date
07/27/2006
Last updated
06/28/2019
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