Provider Demographics
NPI:1164438438
Name:ADVANTACARE HEALTH, INC
Entity Type:Organization
Organization Name:ADVANTACARE HEALTH, INC
Other - Org Name:ADVANTACARE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCCARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-887-1303
Mailing Address - Street 1:5 MANDEVILLE CT
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5745
Mailing Address - Country:US
Mailing Address - Phone:800-481-4662
Mailing Address - Fax:888-654-0003
Practice Address - Street 1:5 MANDEVILLE CT
Practice Address - Street 2:SUITE 400
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5745
Practice Address - Country:US
Practice Address - Phone:800-481-4662
Practice Address - Fax:888-654-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000272332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5746820004Medicare NSC