Provider Demographics
NPI:1538107768
Name:CHAN MEDICAL EQUIPMENT P R INC
Entity Type:Organization
Organization Name:CHAN MEDICAL EQUIPMENT P R INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REMBERTO
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-701-0340
Mailing Address - Street 1:URB VILLA NUEVA CALLE 217
Mailing Address - Street 2:LOCAL II BAJOS CARR 172
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-703-0140
Mailing Address - Fax:787-746-0588
Practice Address - Street 1:URB VILLA NUEVA CALLE 217
Practice Address - Street 2:LOCAL II BAJOS CARR 172
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-703-0140
Practice Address - Fax:787-746-0588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1484332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4479710001Medicare NSC