Provider Demographics
NPI:1316044555
Name:CALVERT HEALTH PARTNERS, LLC
Entity Type:Organization
Organization Name:CALVERT HEALTH PARTNERS, LLC
Other - Org Name:ADVANTAGE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DOMNIC
Authorized Official - Last Name:PETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-230-0001
Mailing Address - Street 1:401 E PRATT ST STE 253
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3041
Mailing Address - Country:US
Mailing Address - Phone:410-230-0001
Mailing Address - Fax:410-230-0031
Practice Address - Street 1:672 BERKMAR CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1464
Practice Address - Country:US
Practice Address - Phone:434-974-9015
Practice Address - Fax:434-974-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========001OtherTRICARE
VA=========001OtherTRICARE