Provider Demographics
NPI:1982654778
Name:BIOCARE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:BIOCARE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:CONCEPCION
Authorized Official - Last Name:LIZARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-466-7666
Mailing Address - Street 1:10134 6TH ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5855
Mailing Address - Country:US
Mailing Address - Phone:909-466-7666
Mailing Address - Fax:909-658-7503
Practice Address - Street 1:10134 6TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5855
Practice Address - Country:US
Practice Address - Phone:909-466-7666
Practice Address - Fax:909-658-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHMDR103277332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME01295FMedicaid
CA0206870001Medicare NSC