Provider Demographics
NPI:1639514151
Name:ADVANCED NURSING CARE INC
Entity Type:Organization
Organization Name:ADVANCED NURSING CARE INC
Other - Org Name:ANC HOMEHEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-696-5045
Mailing Address - Street 1:219 CUTHBERT ST FL 4B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4552
Mailing Address - Country:US
Mailing Address - Phone:610-696-5045
Mailing Address - Fax:267-534-4113
Practice Address - Street 1:219 CUTHBERT ST FL 4B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4552
Practice Address - Country:US
Practice Address - Phone:610-696-5045
Practice Address - Fax:267-534-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04970501251E00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102581115Medicaid