Healthcare Provider Details

I. General information

NPI: 1396574190
Provider Name (Legal Business Name): ACE CARE DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4208 N FREEWAY BLVD STE 1B
SACRAMENTO CA
95834-1241
US

IV. Provider business mailing address

4208 N FREEWAY BLVD STE 1B
SACRAMENTO CA
95834-1241
US

V. Phone/Fax

Practice location:
  • Phone: 707-688-7512
  • Fax:
Mailing address:
  • Phone: 707-688-7512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. HAZEL MAE GAWAT
Title or Position: MANAGING MEMBER
Credential:
Phone: 707-688-7512