Provider Demographics
NPI:1245737626
Name:SURE CARE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:SURE CARE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-448-3080
Mailing Address - Street 1:111 N 2ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4404
Mailing Address - Country:US
Mailing Address - Phone:772-448-3080
Mailing Address - Fax:
Practice Address - Street 1:111 N 2ND ST STE 101
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4404
Practice Address - Country:US
Practice Address - Phone:772-448-3080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies