SUPERCARE DEPOT INC (NPI# 1598376790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598376790 |
| Entity Type | Organization |
| Organization Name | SUPERCARE DEPOT INC |
| Practice Address |
11901 Santa Monica Blvd Ste 470 Los Angeles CA 90025-2767 |
| Practice Telephone | 3104221720 |
| Mailing Telephone | 3104221720 |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | MEHRAN MICHAEL KHALILI (CEO) |
| Authorized Official Telephone | 3104221720 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Supercare Depot Inc | Doing Business As Name - Organization |
| Street Address |
11901 SANTA MONICA BLVD STE 470 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90025-2767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1245852599 | Maureen Bridget Mcglynn | Marriage & Family Therapist | 1531 Purdue Avenue, Los Angeles, CA 90025 | 2020-05-09 |
| 1578118857 | Gregory J Bogie | Physical Therapist | 10351 Santa Monica Blvd. Suite 101, Los Angeles, CA 90025 | 2019-08-05 |
| 1518527712 | David Allen Goldstein | Marriage & Family Therapist | 12301 Wilshire Blvd., Suite 515, Los Angeles, CA 90025 | 2019-06-19 |
| 1386104875 | Kevin Meir Youssefzadeh | Student in an Organized Health Care Education/Training Program | 304 Dowlen Dr, Los Angeles, CA 90025 | 2019-03-21 |
| 1336609189 | Psychotherapy Center for Healing and Personal Growth | Psychologist | 2001 S. Barington Ave Suite 222, Los Angeles, CA 90025 | 2019-03-20 |
| 1477028819 | Flora Ma | Nurse Practitioner | 1726 Purdue Ave, Apt 2, Los Angeles, CA 90025 | 2018-10-12 |
| 1457834285 | Yeesul Yoo | Chiropractor | 2001 S. Barrington Ave Suite 101, Los Angeles, CA 90025 | 2018-09-07 |
| 1902387160 | Angelica Carmen Regalado | Behavior Technician | 7400 Pacific Blvd. Suite A & B, Walnut Park, CA 90025 | 2018-08-26 |
| 1033603378 | Craig Allen Gillett | Marriage & Family Therapist | 11847 Wilshire Blvd., #300, Los Angeles, CA 90025 | 2018-06-20 |
| Find all providers in zip 90025 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484219 | Oa Medicals LLC | Durable Medical Equipment & Medical Supplies | 1704 W Manchester Ave Ste 203, Los Angeles, CA 90047-3057 | 2020-10-16 |
| 1568089548 | Dmg Wellness Inc. | Durable Medical Equipment & Medical Supplies | 2651 Nevin Ave, Los Angeles, CA 90011-2242 | 2020-06-25 |
| 1467073098 | Revive Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 232 E 2nd St Apt 752, Los Angeles, CA 90012-4539 | 2020-05-05 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1386276400 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 8900 S Sepulveda Blvd, Los Angeles, CA 90045-3604 | 2020-02-06 |
| 1366074676 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 415 S La Brea Ave, Los Angeles, CA 90036-3523 | 2020-02-05 |
| 1689214744 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 N Broadway # B101, Los Angeles, CA 90012-4700 | 2020-01-07 |
| 1548816291 | Cath Dry, Inc. | Durable Medical Equipment & Medical Supplies | 1243 N Hoover St, Los Angeles, CA 90029-2009 | 2019-08-16 |
| 1386299139 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1302 South La Brea, Los Angeles, CA 90019 | 2019-08-08 |
| 1336709781 | Anderson Wellness Supplies and Services, LLC | Durable Medical Equipment & Medical Supplies | 777 S Alameda St Fl 2, Los Angeles, CA 90021-1657 | 2019-06-18 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90025 |
Please comment or provide details below to improve the information on SUPERCARE DEPOT INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.