Provider Demographics
NPI:1316020423
Name:VIC MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:VIC MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CARATTINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-738-0526
Mailing Address - Street 1:P O BOX 1322
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-1322
Mailing Address - Country:US
Mailing Address - Phone:787-738-0526
Mailing Address - Fax:
Practice Address - Street 1:BO MONTELLANO CAT.14 KM.72.3
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-0526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies