Provider Demographics
NPI:1679932198
Name:SUPER CARE INC
Entity type:Organization
Organization Name:SUPER CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-206-4880
Mailing Address - Street 1:16017 VALLEY BLVD.
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91744-5424
Mailing Address - Country:US
Mailing Address - Phone:800-206-4880
Mailing Address - Fax:626-723-8275
Practice Address - Street 1:3625 W TECO AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-6818
Practice Address - Country:US
Practice Address - Phone:800-206-4880
Practice Address - Fax:626-723-8275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMP01363332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies