1639489297 NPI number — DIABETIC SOLUTIONS MEDICAL EQUIPMENT & PROSTHETIC CORP

Table of content: (NPI 1639489297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639489297 NPI number — DIABETIC SOLUTIONS MEDICAL EQUIPMENT & PROSTHETIC CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIABETIC SOLUTIONS MEDICAL EQUIPMENT & PROSTHETIC CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639489297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8885 SABANA BRANCH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VEGA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00694-8885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-854-6700
Provider Business Mailing Address Fax Number:
787-854-2000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STREET 3 D12 CORDOVA DAVILA
Provider Second Line Business Practice Location Address:
URB FLAMBOYAN
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-6700
Provider Business Practice Location Address Fax Number:
787-854-2000
Provider Enumeration Date:
10/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
PANTOJA
Authorized Official First Name:
JAIME
Authorized Official Middle Name:
XAVIER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-884-3382

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com