Provider Demographics
NPI:1629815501
Name:HEROCARE EAST LLC
Entity type:Organization
Organization Name:HEROCARE EAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:KURKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:RCP, RRT
Authorized Official - Phone:909-548-0990
Mailing Address - Street 1:7020 HAYVENHURST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7020 HAYVENHURST AVE STE B
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3815
Practice Address - Country:US
Practice Address - Phone:877-915-1556
Practice Address - Fax:909-285-2212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEROCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-09
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition