1629324223 NPI number — UTUADO MEDICAL EQUIPMENT & SUPPLY

Table of content: (NPI 1629324223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629324223 NPI number — UTUADO MEDICAL EQUIPMENT & SUPPLY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UTUADO MEDICAL EQUIPMENT & SUPPLY
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:
1629324223
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE DR. CUETO 15
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UTUADO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-647-5449
Provider Business Mailing Address Fax Number:
787-828-7777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE GUILLERMO ESTEVES
Provider Second Line Business Practice Location Address:
#66
Provider Business Practice Location Address City Name:
JAYUYA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-647-5449
Provider Business Practice Location Address Fax Number:
787-828-7777
Provider Enumeration Date:
08/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SANTIAGO MILLET
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-814-1100

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  14-P-2032 , 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)

  • Identifier: 1558382374 . This is a "NPI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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