Organization
ADVANCED HEALTHCARE ASSOCIATES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAIREE HARGETT (ASST MANAGER, PROVIDER ENROLLMENT)
(775) 222-0042
Entity
Organization
Contact information
Practice address
2300 PARKVIEW LN, ELWOOD, IN 46036-1378
(844) 474-4019
Mailing address
12420 MILESTONE CENTER DR STE 200, GERMANTOWN, MD 20876-7111
(240) 686-2300
(240) 686-2330
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
KY
207R00000X
Internal Medicine Physician
—
IN
207R00000X
Internal Medicine Physician
—
KY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
KY
363L00000X
Nurse Practitioner
—
IN
363L00000X
Nurse Practitioner
—
KY
363LA2200X
Adult Health Nurse Practitioner
—
IN
363LA2200X
Adult Health Nurse Practitioner
—
KY
363LF0000X
Family Nurse Practitioner
—
IN
363LF0000X
Family Nurse Practitioner
—
KY
363LG0600X
Gerontology Nurse Practitioner
—
IN
363LG0600X
Gerontology Nurse Practitioner
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100460560A
—
IN
05
—
7100225520
—
KY
05
—
7100226770
—
KY
01
—
CI1868
RR MEDICARE PIN
IN
01
—
DR2810
RR MEDICARE PIN
KY
Enumeration date
07/12/2006
Last updated
02/24/2023
Update your record
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