Provider Demographics
NPI:1669618633
Name:CARE PROVIDERS MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:CARE PROVIDERS MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAKWENZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-967-8137
Mailing Address - Street 1:500 E CARSON PLAZA DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3225
Mailing Address - Country:US
Mailing Address - Phone:310-967-8137
Mailing Address - Fax:
Practice Address - Street 1:500 E CARSON PLAZA DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3225
Practice Address - Country:US
Practice Address - Phone:310-967-8137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101336280OtherSELLERS PERMIT
CA101336280OtherSELLERS PERMIT