Provider Demographics
NPI:1720005531
Name:ADVACARE HOME SERVICES, INC
Entity Type:Organization
Organization Name:ADVACARE HOME SERVICES, INC
Other - Org Name:ADVACARE HOME SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-677-1171
Mailing Address - Street 1:4451 STATE ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:APOLLO
Mailing Address - State:PA
Mailing Address - Zip Code:15613-2053
Mailing Address - Country:US
Mailing Address - Phone:412-249-9000
Mailing Address - Fax:412-677-1143
Practice Address - Street 1:572 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2229
Practice Address - Country:US
Practice Address - Phone:724-775-8020
Practice Address - Fax:724-775-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016636070005Medicaid