Provider Demographics
NPI:1326912965
Name:INNOCARE MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:INNOCARE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:732-569-0829
Mailing Address - Street 1:44 JUNIPER WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-4610
Mailing Address - Country:US
Mailing Address - Phone:302-640-0445
Mailing Address - Fax:302-663-8235
Practice Address - Street 1:44 JUNIPER WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-4610
Practice Address - Country:US
Practice Address - Phone:302-640-0445
Practice Address - Fax:303-663-8235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies