Provider Demographics
NPI:1417042078
Name:PROMEDS MEDICAL
Entity Type:Organization
Organization Name:PROMEDS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-755-2761
Mailing Address - Street 1:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:SAINT JUST
Mailing Address - State:PR
Mailing Address - Zip Code:00978-0835
Mailing Address - Country:US
Mailing Address - Phone:787-755-2761
Mailing Address - Fax:787-761-6210
Practice Address - Street 1:CALLE ARACIBO A-1
Practice Address - Street 2:URB . VILLAS DE CANEY
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-755-2761
Practice Address - Fax:787-761-6210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4421260001Medicare NSC