Organization
LIFE-CARE HOME HEALTH & MEDICAL SUPPLIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN S NAIM CMOF, BOC (CEO)
(310) 479-0094
Entity
Organization
Contact information
Practice address
11843 WILSHIRE BLVD, WEST LOS ANGELES, CA 90025-6601
(310) 479-0094
Mailing address
11843 WILSHIRE BLVD, WEST LOS ANGELES, CA 90025-6601
(310) 479-0094
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100335
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
100335
CA
335E00000X
Prosthetic/Orthotic Supplier
C17635
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CGP171093
CALIF CHILDRENS SERVICES
CA
05
—
DME01715G
—
CA
Enumeration date
11/15/2006
Last updated
09/19/2007
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