Organization
ADVANCED HOME CARE INC
Active
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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