Provider Demographics
NPI:1376800052
Name:ADVANCED HOME CARE, LLC
Entity Type:Organization
Organization Name:ADVANCED HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:563-260-1399
Mailing Address - Street 1:2925 CEDAR ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-2383
Mailing Address - Country:US
Mailing Address - Phone:563-272-0781
Mailing Address - Fax:563-263-2529
Practice Address - Street 1:2925 CEDAR ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2383
Practice Address - Country:US
Practice Address - Phone:563-272-0781
Practice Address - Fax:563-263-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health