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General NPI Number Information
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NPI Number | 1568799096
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Entity Type | Organization
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Legal Business Name | TOTALCARE MEDICAL SUPPLY & SERVICES
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 7365 CARNELIAN ST STE 112
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1158
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Country | US
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Telephone | 909-941-4000
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Fax | 909-941-4001
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Provider Business Mailing Address
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Address Line | 7365 CARNELIAN ST STE 112
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1158
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Country | US
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Telephone | 909-941-4000
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Fax | 909-941-4001
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Authorized Official
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Title or Position | DIRECTOR
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Name | JIMMY OLADOKUN
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Credential |
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Telephone | 909-941-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 52753
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License Number State | CA
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