# PRO CARE MEDICAL SUPPLIES, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588846083
- **Authorized official:** MR. RENAT PAPSHUOV (CEO/PRESIDENT)
- **Authorized official phone:** (818) 956-0704

## Contact information

- **Practice address:** 1614 VICTORY BLVD, SUITE 104, GLENDALE, CA 91201-2946
- **Practice address phone:** (818) 956-0704
- **Practice address fax:** (818) 956-0714
- **Mailing address:** 1614 VICTORY BLVD, SUITE 104, GLENDALE, CA 91201-2946
- **Mailing address phone:** (818) 956-0704
- **Mailing address fax:** (818) 956-0714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PZUC-20070626 | CA | Yes |

## Other

- **Enumeration date:** 11/27/2007
- **Last updated:** 02/11/2010