Provider Demographics
NPI:1023035847
Name:EXCLUSIVE MEDICAL SERVICES,INC
Entity Type:Organization
Organization Name:EXCLUSIVE MEDICAL SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENTE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RFOM
Authorized Official - Phone:787-804-0070
Mailing Address - Street 1:PO BOX 371
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-0371
Mailing Address - Country:US
Mailing Address - Phone:787-804-0070
Mailing Address - Fax:787-804-0070
Practice Address - Street 1:17 CALLE RODRIGUEZ SERRA
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1925
Practice Address - Country:US
Practice Address - Phone:787-804-0070
Practice Address - Fax:787-804-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4377110001332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4377110001Medicare NSC