Provider Demographics
NPI:1073045928
Name:SUPER CARE, INC.
Entity Type:Organization
Organization Name:SUPER CARE, INC.
Other - Org Name:SUPERCARE HEALTH
Other - Org Type:Doing Business As
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 1:8345 E FIRESTONE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3871
Mailing Address - Country:US
Mailing Address - Phone:800-206-4880
Mailing Address - Fax:
Practice Address - Street 1:7243 ENGINEER RD
Practice Address - Street 2:SUITE E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1437
Practice Address - Country:US
Practice Address - Phone:800-260-4880
Practice Address - Fax:626-723-8275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79915332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies