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
4001 PIEDMONT PKWY, HIGH POINT, NC 27265-9402
(336) 878-8822
(336) 878-8853
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(336) 878-8822
(336) 878-8853
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
05113
NC
332B00000X
Durable Medical Equipment & Medical Supplies
—
NC
332BC3200X
Customized Equipment (DME)
00786
NC
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
05113
NC
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
00786
NC
333600000X
Pharmacy
05113
NC
3336H0001X
Home Infusion Therapy Pharmacy
0533
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0244470001
NATIONAL SUPPLIER CLEARINGHOUSE
NC
05
—
0347007
—
NC
01
—
0486P
BCBSNC DME
NC
01
—
0494A
BCBSNC IV
NC
01
—
1013981
UHC ACM
NC
01
—
153369400
BLACK LUNG
NC
01
—
3429669
NCPDP
NC
05
—
6800401
—
NC
05
—
7702497
—
NC
01
—
8295
PARTNERS
NC
Enumeration date
01/02/2006
Last updated
11/16/2018
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