Provider Demographics
NPI:1407905565
Name:TRUE CARE DURABLE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:TRUE CARE DURABLE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-747-2253
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-0315
Mailing Address - Country:US
Mailing Address - Phone:708-225-1541
Mailing Address - Fax:877-747-2293
Practice Address - Street 1:17135 WESTVIEW AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2755
Practice Address - Country:US
Practice Address - Phone:708-747-2253
Practice Address - Fax:877-747-2293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4128954Medicaid
IL=========001Medicaid
IL=========001Medicaid