Provider Demographics
NPI:1972301620
Name:CALICARE MED SUPPLIES LLC
Entity type:Organization
Organization Name:CALICARE MED SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMEH
Authorized Official - Middle Name:A
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-222-4705
Mailing Address - Street 1:4225 EXECUTIVE SQUARE
Mailing Address - Street 2:STE 600 UNIT 31
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-222-4705
Mailing Address - Fax:
Practice Address - Street 1:4225 EXECUTIVE SQUARE
Practice Address - Street 2:STE 600 UNIT 31
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-222-4705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies