Provider Demographics
NPI:1851553952
Name:ADVOCARE , LLC
Entity type:Organization
Organization Name:ADVOCARE , LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-872-7053
Mailing Address - Street 1:401 ROUTE 73 N BLDG 10, SUITE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-427-4180
Mailing Address - Fax:877-531-4772
Practice Address - Street 1:1401 ROUTE 70 E STE 16
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2207
Practice Address - Country:US
Practice Address - Phone:856-427-4180
Practice Address - Fax:856-427-4181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-30
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
31D0996061OtherCLIA
NJ077356Medicare PIN