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
5901 GOSHEN SPRINGS RD, STE G, NORCROSS, GA 30071
(770) 449-6898
(800) 311-7783
Mailing address
PO BOX 18049, GREENSBORO, NC 27419-8049
(336) 878-8950
(336) 878-8883
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHRE010124
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141266A
—
GA
01
—
1164805
NCPDP
GA
Enumeration date
11/25/2013
Last updated
03/07/2023
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