MEDICARE: SUPER CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1093557985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPER CARE, LLC

Provider Business Mailing Address
First Line	:	16017 VALLEY BLVD
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91744-5424
Country	:	US
Telephone Number	:	877-876-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	3702 E ROESER RD STE 7
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-9047
Country	:	US
Telephone Number	:	800-206-4880
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN L CASSAR
Credential	:
Telephone Number	:	800-206-4880

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	03/20/2026

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Directions to “SUPER CARE, LLC ” Practice Location

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