Provider Demographics
NPI:1497842652
Name:RECOVER CARE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:RECOVER CARE MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DR PH
Authorized Official - Phone:817-310-1100
Mailing Address - Street 1:1110 N CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5306
Mailing Address - Country:US
Mailing Address - Phone:817-310-1100
Mailing Address - Fax:817-310-1197
Practice Address - Street 1:580 AVE DE DIEGO
Practice Address - Street 2:BAJOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-3723
Practice Address - Country:US
Practice Address - Phone:787-620-5574
Practice Address - Fax:787-620-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR114558332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR114558OtherSTATE LICENSE NUMBER
PR114558OtherSTATE LICENSE NUMBER