ADVANCED HOME CARE, INC.

Provider Demographics

• NPI: 1063492726
• Name: ADVANCED HOME CARE, INC.
• Entity Type: Organization
• Organization Name: ADVANCED HOME CARE, INC.
• Authorized Official - Title/Position: CREDENTIALING SPECIALIST
• Authorized Official - First Name: MIKE
• Authorized Official - Last Name: KALBAUGH
• Authorized Official - Phone: 336-878-8824
• Mailing Address - Street 1: PO BOX 18049
• Mailing Address - City: GREENSBORO
• Mailing Address - State: NC
• Mailing Address - Zip Code: 27419-8049
• Mailing Address - Country: US
• Mailing Address - Phone: 336-878-8950
• Mailing Address - Fax: 336-878-8896
• Practice Address - Street 1: 2520 WHITEHALL PARK DR
• Practice Address - Street 2: SUITE 950
• Practice Address - City: CHARLOTTE
• Practice Address - State: NC
• Practice Address - Zip Code: 28273-3557
• Practice Address - Country: US
• Practice Address - Phone: 704-831-5000
• Practice Address - Fax: 877-242-3291
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-01-19
• Last Update Date: 2017-11-21

Provider Licenses

State	License ID	Taxonomies
NC	07151	251F00000X, 333600000X
NC	00355	332B00000X, 332BP3500X, 332BX2000X
NC		3336H0001X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies
No	251F00000X	Agencies	Home Infusion
No	332BP3500X	Suppliers	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition
No	332BX2000X	Suppliers	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies
No	333600000X	Suppliers	Pharmacy
No	3336H0001X	Suppliers	Pharmacy	Home Infusion Therapy Pharmacy

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NC	1013981	Other	UHC ACM
NC	8295	Other	PARTNERS
SC	DE7291	Medicaid
NC	0609016	Medicaid
NC	0494A	Other	BCBSNC IV
NC	3429669	Other	NCPDP
NC	6800431	Medicaid
SC	7N5113	Medicaid
NC	7702486	Medicaid
NC	0486P	Other	BCBSNC DME
NC	3429669	Other	NCPDP