Provider Demographics
NPI:1275927550
Name:CARE GIVER SUPPORT PRODUCTS, LLC
Entity Type:Organization
Organization Name:CARE GIVER SUPPORT PRODUCTS, LLC
Other - Org Name:FAWSSIT PORTABLE SHOWERS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER / PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:LAUER
Authorized Official - Last Name:SEIDMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:510-569-2627
Mailing Address - Street 1:415 WOODLAND PARK
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3733
Mailing Address - Country:US
Mailing Address - Phone:510-569-2627
Mailing Address - Fax:510-315-3057
Practice Address - Street 1:723 S CASINO CENTER BLVD
Practice Address - Street 2:FLOOR 2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6716
Practice Address - Country:US
Practice Address - Phone:510-569-2627
Practice Address - Fax:510-315-3057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201022210234332BC3200X
NVNV20051673028332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment