Healthcare Provider Details

I. General information

NPI: 1689915274
Provider Name (Legal Business Name): BIOCARE MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9830 6TH STREET SUITE 103
RANCHO CUCAMONGA CA
91730-7969
US

IV. Provider business mailing address

9830 6TH STREET SUITE 103
RANCHO CUCAMONGA CA
91730-7969
US

V. Phone/Fax

Practice location:
  • Phone: 909-466-4111
  • Fax: 951-572-3745
Mailing address:
  • Phone: 909-466-4111
  • Fax: 951-572-3745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. TERRY LEE MOFFIT
Title or Position: GENERAL MANAGER
Credential:
Phone: 855-476-7679