Provider Demographics
NPI:1215738893
Name:SUPER CARE INC
Entity type:Organization
Organization Name:SUPER CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-206-4880
Mailing Address - Street 1:16017 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91744-5424
Mailing Address - Country:US
Mailing Address - Phone:877-876-9275
Mailing Address - Fax:
Practice Address - Street 1:12176 INDUSTRIAL BLVD STE 4
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5879
Practice Address - Country:US
Practice Address - Phone:800-206-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies