Provider Demographics
NPI:1063808665
Name:ADVANCED MEDICAL CARE, INC
Entity type:Organization
Organization Name:ADVANCED MEDICAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-221-7169
Mailing Address - Street 1:6 FARMINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2135
Mailing Address - Country:US
Mailing Address - Phone:856-696-9697
Mailing Address - Fax:856-691-0440
Practice Address - Street 1:521 S WEST AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5249
Practice Address - Country:US
Practice Address - Phone:856-696-9697
Practice Address - Fax:856-691-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05665700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty