Provider Demographics
NPI:1265968564
Name:PROCARE NETWORK INC
Entity type:Organization
Organization Name:PROCARE NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEKEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-837-3087
Mailing Address - Street 1:500 E CARSON PLAZA DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-3225
Mailing Address - Country:US
Mailing Address - Phone:866-837-3087
Mailing Address - Fax:323-484-2119
Practice Address - Street 1:500 E CARSON PLAZA DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3225
Practice Address - Country:US
Practice Address - Phone:866-837-3087
Practice Address - Fax:323-484-2119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 503159343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)