Provider Demographics
NPI:1255609756
Name:ADVOCARE, LLC
Entity type:Organization
Organization Name:ADVOCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TEDESCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-782-3300
Mailing Address - Street 1:PO BOX 3001
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0598
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:218 RIDGEDALE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2109
Practice Address - Country:US
Practice Address - Phone:973-538-7700
Practice Address - Fax:973-538-9478
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-12
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty