1760735674 NPI number — HOME ORTHOPEDICAL EQUIPMENT, CORP.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760735674 NPI number — HOME ORTHOPEDICAL EQUIPMENT, CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME ORTHOPEDICAL EQUIPMENT, 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:
HOME ORTHOPEDICAL
Provider Other Organization Name Type Code:
4
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:
1760735674
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LAS LEANDRAS STATION
Provider Second Line Business Mailing Address:
PMB 133 C3 R20
Provider Business Mailing Address City Name:
HUMACAO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-226-2892
Provider Business Mailing Address Fax Number:
787-850-6398

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE GABRIEL HERNANDEZ #23
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-226-2892
Provider Business Practice Location Address Fax Number:
787-850-6398
Provider Enumeration Date:
10/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TOLENTINO
Authorized Official First Name:
LISSETE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER & PRESIDENT
Authorized Official Telephone Number:
787-514-8349

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0508399-0021 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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