Provider Demographics
NPI:1396854907
Name:LAC MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:LAC MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-837-5617
Mailing Address - Street 1:APARTADO 469
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-0469
Mailing Address - Country:US
Mailing Address - Phone:787-837-5617
Mailing Address - Fax:787-837-5617
Practice Address - Street 1:CALLE TOMAS CARRION MADURO #60
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-1638
Practice Address - Country:US
Practice Address - Phone:787-937-5617
Practice Address - Fax:787-837-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR300OE332B00000X
PR08P2347332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5877790001Medicare NSC