Provider Demographics
NPI:1477706547
Name:CARE MED-EQUIP LLC
Entity Type:Organization
Organization Name:CARE MED-EQUIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-341-2586
Mailing Address - Street 1:14175 STATE ROUTE O
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-6245
Mailing Address - Country:US
Mailing Address - Phone:573-341-2586
Mailing Address - Fax:
Practice Address - Street 1:14175 STATE ROUTE O
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-6245
Practice Address - Country:US
Practice Address - Phone:573-341-2586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies