Provider Demographics
NPI:1649919945
Name:ADULT CARE SUPPLY, LLC
Entity type:Organization
Organization Name:ADULT CARE SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:POURKAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-339-7852
Mailing Address - Street 1:1315 NW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-6055
Mailing Address - Country:US
Mailing Address - Phone:239-339-7852
Mailing Address - Fax:
Practice Address - Street 1:1315 NW 11TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-6055
Practice Address - Country:US
Practice Address - Phone:239-339-7852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies