Provider Demographics
NPI:1609108430
Name:ADVACARE HOME SERVICES, INC
Entity Type:Organization
Organization Name:ADVACARE HOME SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZELENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-677-1171
Mailing Address - Street 1:200 VILLANI DR
Mailing Address - Street 2:SUITE 3009
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-3483
Mailing Address - Country:US
Mailing Address - Phone:412-249-9000
Mailing Address - Fax:412-249-9036
Practice Address - Street 1:160 PITTSBURGH ST
Practice Address - Street 2:SUITE 10A
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2300
Practice Address - Country:US
Practice Address - Phone:412-249-9000
Practice Address - Fax:412-249-9036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1188550004Medicare NSC