Provider Demographics
NPI:1083865661
Name:RIOS MEDICAL SUPPLY,INC.
Entity Type:Organization
Organization Name:RIOS MEDICAL SUPPLY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:RIOS BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-508-0121
Mailing Address - Street 1:427 W DUSSEL DR
Mailing Address - Street 2:SUITE 336
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-4208
Mailing Address - Country:US
Mailing Address - Phone:419-508-0121
Mailing Address - Fax:
Practice Address - Street 1:6725 W CENTRAL AVE
Practice Address - Street 2:SUITE: M #357
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1148
Practice Address - Country:US
Practice Address - Phone:419-508-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty