Provider Demographics
NPI:1407833304
Name:AGA LINDE HEALTHCARE PR INC
Entity Type:Organization
Organization Name:AGA LINDE HEALTHCARE PR INC
Other - Org Name:MED CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT - HOMECARE
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-620-8120
Mailing Address - Street 1:PO BOX 364727
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4727
Mailing Address - Country:US
Mailing Address - Phone:787-620-8120
Mailing Address - Fax:787-620-8267
Practice Address - Street 1:CARR 869 KM 2.0 PALMAS VILLAGE
Practice Address - Street 2:BO. PALMAS
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:787-620-8120
Practice Address - Fax:787-620-8267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08-F-2427332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0622170006Medicare ID - Type Unspecified