MEDICARE: BLUE CORE MED SUPPLIES LLC

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	:	1548110844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE CORE MED SUPPLIES LLC

Provider Business Mailing Address
First Line	:	1013 N COTTAGE ST
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64050-1742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 N COTTAGE ST
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64050-1742
Country	:	US
Telephone Number	:	816-394-9834
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	XAVIER DANTE
Credential	:
Telephone Number	:	229-667-5465

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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