Provider Demographics
NPI:1922288042
Name:ADVANCE INCARE SUPPLY GROUP, INC.
Entity Type:Organization
Organization Name:ADVANCE INCARE SUPPLY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAQUIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-953-2997
Mailing Address - Street 1:551 E 49TH ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1904
Mailing Address - Country:US
Mailing Address - Phone:305-953-2997
Mailing Address - Fax:
Practice Address - Street 1:551 E 49TH ST
Practice Address - Street 2:SUITE 11
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1904
Practice Address - Country:US
Practice Address - Phone:305-696-5315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6161410001Medicare NSC