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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 24153-5568
(540) 389-8121
(540) 389-8128
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(336) 878-8950
(336) 878-8853

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0206008324
VA
332BC3200X
Customized Equipment (DME)
0206008324
VA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0201003184
VA
332BX2000X
Oxygen Equipment & Supplies (DME)
0206008324
VA
333600000X
Pharmacy
0201003184
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010115566
VA
05
010115591
VA
01
1013981
UHC ACM
VA
01
168466
ANTHEM IV
VA
01
432916
ANTHEM DME
VA
Enumeration date
03/03/2006
Last updated
10/09/2017
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