Organization · NPI-2
Advocare , LLC
Pediatrics, Adolescent Medicine · Philadelphia, PA
NPI number1386288702
StatusActive
Last updated in NPPESSep 16, 2022
Details
- NPI
- 1386288702
- Entity type
- Organization (NPI-2)
- Legal business name
- Advocare , LLC
- Organization subpart
- Yes
- Enumeration date
- Oct 29, 2019
- Certification date
- Sep 16, 2022
- Last updated
- Sep 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080A0000X | Pediatrics, Adolescent Medicine | – | – | Yes |
Other names
- Advocare Fairmount Pediatrics And Adolescent Medicine (Other Name)
Practice location
2000 Hamilton St Ste 109Philadelphia, PA 19130-3847
Phone 215-774-1166
Mailing address
Po Box 71422Philadelphia, PA 19176-1422
Phone 856-872-7055 · Fax 856-504-8029
Authorized official
Charles Mcqueary
Executive Vp And Coo
8568727052
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