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General NPI Number Information
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NPI Number | 1710050307
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Entity Type | Organization
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Legal Business Name | LIFE-CARE HOME HEALTH & MEDICAL SUPPLIES, INC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 11843 WILSHIRE BLVD
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City | WEST LOS ANGELES
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State | CA
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Zip | 90025-6601
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Country | US
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Telephone | 310-479-0094
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Fax |
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Provider Business Mailing Address
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Address Line | 11843 WILSHIRE BLVD
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City | WEST LOS ANGELES
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State | CA
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Zip | 90025-6601
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Country | US
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Telephone | 310-479-0094
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHAWN S NAIM
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Credential | CMOF, BOC
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Telephone | 310-479-0094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 100335
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | C17635
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 100335
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License Number State | CA
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