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
5901 GOSHEN SPRINGS RD, SUITE G, NORCROSS, GA 30071
(770) 449-6898
(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
PHRE010124
GA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PHRE010124
GA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHRE010124
GA
332BX2000X
Oxygen Equipment & Supplies (DME)
PHWH003765
GA
333600000X
Pharmacy
PHRE010124
GA
3336H0001X
Home Infusion Therapy Pharmacy
PHRE010124
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
975916385A
—
GA
Enumeration date
12/24/2012
Last updated
08/09/2018
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