MEDICARE: SUPER CARE 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	102189	CA
2	333600000X	Pharmacy	BS7954375	CA
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1902863202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPER CARE INC

Provider Business Mailing Address
First Line	:	16017 VALLEY BLVD
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91744-5424
Country	:	US
Telephone Number	:	626-854-2283
Fax Number	:	626-854-2278

Provider Business Practice Location Address
First Line	:	16017 VALLEY BLVD
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91744-5424
Country	:	US
Telephone Number	:	626-854-2283
Fax Number	:	626-854-2278

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN L. CASSAR
Credential	:
Telephone Number	:	626-854-2283

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	11/14/2024

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Directions to “SUPER CARE INC ” Practice Location

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