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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
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