Provider Demographics
NPI:1033103163
Name:MONSERRATE SALES AND RENTAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:MONSERRATE SALES AND RENTAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:V
Authorized Official - Last Name:CLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-754-0449
Mailing Address - Street 1:PO BOX 366148
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6148
Mailing Address - Country:US
Mailing Address - Phone:787-754-0449
Mailing Address - Fax:787-751-4204
Practice Address - Street 1:1517 CALLE PARANA
Practice Address - Street 2:URB. EL PARAISO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2814
Practice Address - Country:US
Practice Address - Phone:787-754-0449
Practice Address - Fax:787-751-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-03
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 335E00000X
PR05-P-1761332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0399730001Medicare ID - Type UnspecifiedDME, ORTOTIC