MEDICARE: ACTIVE CARE SUPPLY 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	:	1982546982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE CARE SUPPLY LLC

Provider Business Mailing Address
First Line	:	6600 CHUKKAR LN
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-1319
Country	:	US
Telephone Number	:	972-800-5154
Fax Number	:	972-800-5154

Provider Business Practice Location Address
First Line	:	6600 CHUKKAR LN
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-1319
Country	:	US
Telephone Number	:	972-800-5154
Fax Number	:	972-800-5154

Authorized Official
Title or Position	:	CEO
Name	:	MILTON CASTILLO
Credential	:
Telephone Number	:	972-800-5154

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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