Provider Demographics
NPI:1073837274
Name:CARE MEDICAL & SURGICAL SUPPLIES
Entity Type:Organization
Organization Name:CARE MEDICAL & SURGICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKAMIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-965-3632
Mailing Address - Street 1:8116B MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3756
Mailing Address - Country:US
Mailing Address - Phone:916-965-3632
Mailing Address - Fax:916-965-6365
Practice Address - Street 1:8116B MADISON AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3756
Practice Address - Country:US
Practice Address - Phone:916-965-3632
Practice Address - Fax:916-965-6365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49039332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies