Provider Demographics
NPI:1790121291
Name:ADVANCED MEDICAL HOME CARE LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:612-267-6154
Mailing Address - Street 1:206 LITTLE CANADA RD E
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1332
Mailing Address - Country:US
Mailing Address - Phone:612-267-6154
Mailing Address - Fax:651-762-2454
Practice Address - Street 1:206 LITTLE CANADA RD E
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55117-1332
Practice Address - Country:US
Practice Address - Phone:612-267-6154
Practice Address - Fax:855-316-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-11
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH29186251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health