Healthcare Provider Details

I. General information

NPI: 1962504654
Provider Name (Legal Business Name): ALL-CARE MEDICAL SUPPLY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8937 S WESTERN AVE
LOS ANGELES CA
90047-3549
US

IV. Provider business mailing address

8937 S WESTERN AVE
LOS ANGELES CA
90047-3549
US

V. Phone/Fax

Practice location:
  • Phone: 323-750-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: LISA DAVIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-750-7800