Provider Demographics
NPI:1477213080
Name:K&P MEDICAL SUPPLY DISTRIBUTORS, CORP
Entity Type:Organization
Organization Name:K&P MEDICAL SUPPLY DISTRIBUTORS, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INES
Authorized Official - Middle Name:Y
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-651-4901
Mailing Address - Street 1:508 AVE TITO CASTRO
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-4707
Mailing Address - Country:US
Mailing Address - Phone:787-651-4901
Mailing Address - Fax:787-651-4901
Practice Address - Street 1:508 AVE TITO CASTRO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4707
Practice Address - Country:US
Practice Address - Phone:787-651-4901
Practice Address - Fax:787-651-4901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies