Provider Demographics
NPI:1265457063
Name:QUALITY CARE MEDICAL SUPPLY AND EQUIPMENT CORP
Entity Type:Organization
Organization Name:QUALITY CARE MEDICAL SUPPLY AND EQUIPMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-263-1964
Mailing Address - Street 1:P.O. BOX 547
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-0547
Mailing Address - Country:US
Mailing Address - Phone:787-857-7272
Mailing Address - Fax:787-947-6684
Practice Address - Street 1:43 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1710
Practice Address - Country:US
Practice Address - Phone:787-857-7272
Practice Address - Fax:787-947-6684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5164030001Medicare NSC