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
72 SAINT JOHNS PLACE RD, SALEM, VA 24153
(540) 389-8121
(800) 311-7783
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(336) 878-8950
(800) 311-7783
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010115591
—
VA
01
—
1013981
UHC ACM
VA
01
—
168466
ANTHEM
VA
01
—
432916
ANTHEM
VA
Enumeration date
10/18/2006
Last updated
06/18/2018
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