| Organization Name: | CENTRAL CARE MEDICAL SUPPLIES, LLC |
| NPI Number: | 1578749420 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA A. EDWARDS (PRESIDENT) |
| Mailing Address: | 9244 E Hampton Dr 631 Capitol Heights |
| State: | MD US |
| Postal Code: | 207433858 |
| Phone Number: | 8665856704 |
| Fax Number: | 8662610478 |
| NPI Enumeration Date: | 01/10/2008 |
| NPI Last Update Date: | 07/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | R2586 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |