Provider Demographics
NPI:1154344521
Name:HEALTH ADVANCE, LLC
Entity type:Organization
Organization Name:HEALTH ADVANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH, CDE
Authorized Official - Phone:410-203-9875
Mailing Address - Street 1:2712 ROCKY GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-203-9875
Mailing Address - Fax:410-203-9872
Practice Address - Street 1:2712 ROCKY GLEN WAY
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:410-203-9875
Practice Address - Fax:410-203-9872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141801835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty