Provider Demographics
NPI:1730195066
Name:ADVANTACARE HEALTH INC
Entity type:Organization
Organization Name:ADVANTACARE HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:DUNCAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:831-887-1301
Mailing Address - Street 1:5 MANDEVILLE CT
Mailing Address - Street 2:STE 100
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5745
Mailing Address - Country:US
Mailing Address - Phone:800-481-4662
Mailing Address - Fax:888-654-0003
Practice Address - Street 1:5 MANDEVILLE CT
Practice Address - Street 2:STE 100
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5745
Practice Address - Country:US
Practice Address - Phone:800-481-4662
Practice Address - Fax:888-654-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X, 333600000X
CAPHY483233336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA483230Medicaid
2004658OtherPK
CA5746820001Medicare NSC