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SUPREME HEALTHCARE
NPI 1902307713
Durable Medical Equipment & Medical Supplies in San Dimas, CA

Active since February 27, 2018
433 W ALLEN AVE STE 112, SAN DIMAS, CA 91773(909) 657-5557(909) 657-9990 Get Directions Write a Review

NPPES record last updated: January 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 21, 2022, Jun 14, 2019, Dec 20, 2018 and 3 more (6 updates tracked since 2018).

About Supreme Healthcare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPREME HEALTHCARE (NPI 1902307713) is a healthcare organization registered as a durable medical equipment & medical supplies in San Dimas, California and active in the NPI registry since February 2018. The organization lists Arnold Aquino, President, as its authorized official.

NPPES Registry Identity

NPI1902307713
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameMIRA INTEGRATED HOLDINGS INC
Location Address433 W ALLEN AVE STE 112San Dimas, CA 91773-4704
Mailing Address433 W Allen Ave Ste 112San Dimas, CA 91773-4704 · (909) 657-5557 · Fax (909) 657-9990
Phone(909) 657-5557
Fax(909) 657-9990
Organization SubpartNo
Authorized OfficialArnold AquinoPresident · (909) 657-5557
Enumeration DateFebruary 27, 2018
Last NPPES UpdateJanuary 21, 20226 updates tracked since enumeration
NPPES CertifiedJanuary 21, 2022
✔ NPI 1902307713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
License✔ Licensed in CA · 98254
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's use in the home and that are usable for an extended period of time.
433 W ALLEN AVE STE 112, San Dimas, CA 91773
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Other Names 1

Doing Business AsSupreme Healthcare

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Supreme Healthcare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20181219000714DME · Medical Supply Company with Respiratory TherapistDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Medical Equipment Supplier Medicare DMEPOS 13

Medicare supplier enrollment and the product categories Supreme Healthcare carries, from the Medicare DMEPOS supplier directory.

Supreme Healthcare

DMEPOS supplier · San Dimas, CAOperated by Mira Integrated Holdings Inc
✔

Accepts Medicare assignment

Supreme Healthcare agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20453309
Medicare Participant SinceOctober 1, 2018
Supplier Location433 W Allen Ave Ste 112San Dimas, CA 91773
Phone(909) 657-5557
Provider TypeOxygen & Equipment
Supplier Specialties
Medical Supply Company Other MSC With Respiratory Therapist

Medicare Product Categories

Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies
Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Walkers
Standard Walkers, Wheeled Walkers, Folding Walker
Tracheotomy Supplies
Tracheostomy care kits
Continuous Positive Airway Pressure (CPAP) Devices
CPAP machines, Compressor systems, Humidifiers, Masks
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mira Integrated Holdings Inc's NPI number?

The NPI number for Mira Integrated Holdings Inc is 1902307713. It was assigned to this organization in the NPPES registry on February 27, 2018. The provider is doing business as Supreme Healthcare.

Where is Mira Integrated Holdings Inc located?

Mira Integrated Holdings Inc is located at 433 W Allen Ave Ste 112, San Dimas, CA 91773. The listed phone number is (909) 657-5557.

What is Mira Integrated Holdings Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Is Mira Integrated Holdings Inc enrolled in Medicare?

Yes. Mira Integrated Holdings Inc is registered in the Medicare PECOS enrollment system.

When is Mira Integrated Holdings Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (California, Medical Supply Company with Respiratory Therapist) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Mira Integrated Holdings Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Supreme Healthcare accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Mira Integrated Holdings Inc was last updated on January 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.