Provider Demographics
NPI:1962158758
Name:NEW CARE
Entity type:Organization
Organization Name:NEW CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIROLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRAWOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-383-5711
Mailing Address - Street 1:6825 SAN RAFAEL CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5064
Mailing Address - Country:US
Mailing Address - Phone:626-383-5711
Mailing Address - Fax:
Practice Address - Street 1:12384 PALMDALE RD STE 105
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-8506
Practice Address - Country:US
Practice Address - Phone:626-383-5711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy