MEDICARE: NEXCARE SUPPLY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1063381275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXCARE SUPPLY INC

Provider Business Mailing Address
First Line	:	5742 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5742 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1627
Country	:	US
Telephone Number	:	818-856-8050
Fax Number	:	818-856-8051

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AIBEK IBRAIMOV
Credential	:
Telephone Number	:	818-856-8050

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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