Provider Demographics
NPI:1720678774
Name:ADVANCED VALUE CARE, LLC
Entity Type:Organization
Organization Name:ADVANCED VALUE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-833-7030
Mailing Address - Street 1:31 SOUTH ST STE 3S8
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1752
Mailing Address - Country:US
Mailing Address - Phone:845-205-2756
Mailing Address - Fax:845-367-5503
Practice Address - Street 1:31 SOUTH ST STE 3S8
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1752
Practice Address - Country:US
Practice Address - Phone:845-205-2756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty