Provider Demographics
NPI:1942216577
Name:UNICARE DIAGNOSTICS INC
Entity Type:Organization
Organization Name:UNICARE DIAGNOSTICS INC
Other - Org Name:BREATHE RITE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:805-375-0033
Mailing Address - Street 1:3271 GRANDE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-1193
Mailing Address - Country:US
Mailing Address - Phone:805-375-0033
Mailing Address - Fax:805-375-3972
Practice Address - Street 1:3271 GRANDE VISTA DR
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-1193
Practice Address - Country:US
Practice Address - Phone:805-375-0033
Practice Address - Fax:805-375-3972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY45291332B00000X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA452910Medicaid
0514174OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0531100001Medicare NSC