Provider Demographics
NPI:1043285497
Name:INTERNATIONAL MEDICAL EQUIPMENT CORPORATION
Entity Type:Organization
Organization Name:INTERNATIONAL MEDICAL EQUIPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO-SANTOS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:787-780-6441
Mailing Address - Street 1:PMB 490
Mailing Address - Street 2:PO BOX 607061
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7061
Mailing Address - Country:US
Mailing Address - Phone:787-780-6441
Mailing Address - Fax:787-269-3190
Practice Address - Street 1:HERMANAS DAVILA AVE.
Practice Address - Street 2:M8A URB. SAN FERNANDO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-2201
Practice Address - Country:US
Practice Address - Phone:787-780-6441
Practice Address - Fax:787-269-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR05-P-1634332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0627850001Medicare ID - Type Unspecified