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
3780 EISENHOWER PKWY, 5, MACON, GA 31206-0805
(478) 785-6455
(800) 311-7783
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(800) 868-8822
(800) 311-7783
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
TO BE ISSUED
GA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
TO BE ISSUED
GA
332BX2000X
Oxygen Equipment & Supplies (DME)
TO BE ISSUED
GA
3336H0001X
Home Infusion Therapy Pharmacy
TO BE ADDED
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003161782A
—
GA
Enumeration date
06/24/2014
Last updated
11/21/2017
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