MEDICARE: ALL-CARE MEDICAL SUPPLY CORPORATION

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	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ50931Z	OTHER	CA	BLUE SHIELD OF CA

General Provider Information

NPI Number	:	1962504654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL-CARE MEDICAL SUPPLY CORPORATION

Provider Business Mailing Address
First Line	:	8937 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3549
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8937 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3549
Country	:	US
Telephone Number	:	323-750-7800
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LISA DAVIS
Credential	:
Telephone Number	:	323-750-7800

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	06/18/2008

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Directions to “ALL-CARE MEDICAL SUPPLY CORPORATION ” Practice Location

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