MEDICARE: ALL CARE MEDICAL SUPPLY 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	332B00000X	Durable Medical Equipment & Medical Supplies		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902025604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL CARE MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	1213 FOSTER AVE # 1215
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1607
Country	:	US
Telephone Number	:	718-859-3493
Fax Number	:	718-859-3495

Provider Business Practice Location Address
First Line	:	1213 FOSTER AVE # 1215
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1607
Country	:	US
Telephone Number	:	718-859-3493
Fax Number	:	718-859-3495

Authorized Official
Title or Position	:	OWNER
Name	:	OFELIYA ILISHAYEVA
Credential	:
Telephone Number	:	718-859-3493

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/22/2020

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