Organization
EQUICARE MEDICAL SUPPLY, INC.
Active
Parent organization
EQUICARE MEDICAL SUPPLY, INC.
Other names
EMERALD TERRACE CONVALESCENT HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
EQUICARE MEDICAL SUPPLY, INC.
Authorized official
MS. CRISTINA BERNARDO MENDOZA BNHA6137 (ADMINISTRATOR)
(213) 385-1715
Entity
Organization
Contact information
Practice address
1154 S ALVARADO ST, LOS ANGELES, CA 90006-4110
(213) 385-1715
(213) 385-7802
Mailing address
1154 S ALVARADO ST, LOS ANGELES, CA 90006-4110
(213) 385-1715
(213) 385-7802
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
970000064
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT06157I
—
CA
Enumeration date
11/22/2005
Last updated
05/26/2011
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