Procare Medical Supply and Distribution Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

332B00000X Issued in CA

Legal business name

PROCARE MEDICAL SUPPLY AND DISTRIBUTION INC

Practice address

1910 W Redondo Beach Blvd
Gardena, CA 90247-3624

Phone

(310) 515-0507

Fax

(310) 515-1668

NPI assigned

Oct 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew Adedapo Adesida

Title

President

Phone

(310) 748-9904

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407945249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473624",
            "telephone_number": "310-515-0507",
            "fax_number": "310-515-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473624",
            "telephone_number": "310-515-0507",
            "fax_number": "310-515-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE MEDICAL SUPPLY AND DISTRIBUTION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADESIDA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ADEDAPO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-748-9904"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "332B00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Gardena, CA
• Providers in Gardena, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.