1265511141 NPI number — MEDCO MEDICAL EQUIPMENT INC

Table of content: (NPI 1265511141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265511141 NPI number — MEDCO MEDICAL EQUIPMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDCO MEDICAL EQUIPMENT INC
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:
MEDCO PHARMACY
Provider Other Organization Name Type Code:
3
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:
1265511141
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3044
Provider Second Line Business Mailing Address:
HATO ARRIBA STATION
Provider Business Mailing Address City Name:
SAN SEBASTIAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00685
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-818-3755
Provider Business Mailing Address Fax Number:
787-818-3825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
EDIFICIO VALE COLON OFICINA #10
Provider Second Line Business Practice Location Address:
CARR 111 KM 3.5 BO PUEBLO
Provider Business Practice Location Address City Name:
MOCA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00676
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-818-3755
Provider Business Practice Location Address Fax Number:
787-818-3825
Provider Enumeration Date:
11/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ORTIZ RODRIGUEZ
Authorized Official First Name:
JAVIER
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-818-3755

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  4551660001 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 333600000X , with the licence number: 4551660002 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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