Provider Demographics
NPI:1922588052
Name:SUPERCARE, INC.
Entity Type:Organization
Organization Name:SUPERCARE, INC.
Other - Org Name:SUPERCARE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-206-4880
Mailing Address - Street 1:8345 E. FIRESTONE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3871
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4717 OSBORNE DR STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-1035
Practice Address - Country:US
Practice Address - Phone:800-206-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001560332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies