Provider Demographics
NPI:1104117829
Name:ADVANCED PRO HOME CARE, INC
Entity type:Organization
Organization Name:ADVANCED PRO HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-451-0707
Mailing Address - Street 1:317 BRICK BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6031
Mailing Address - Country:US
Mailing Address - Phone:732-451-0707
Mailing Address - Fax:732-451-0040
Practice Address - Street 1:317 BRICK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6031
Practice Address - Country:US
Practice Address - Phone:732-451-0707
Practice Address - Fax:732-451-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0145700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health