Provider Demographics
NPI:1548236318
Name:OR PRO MEDICAL INC
Entity Type:Organization
Organization Name:OR PRO MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROTHETIST ORTHOTIS
Authorized Official - Prefix:MR
Authorized Official - First Name:BENIGNO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:787-848-3873
Mailing Address - Street 1:23 CAMPECHE STREET
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731
Mailing Address - Country:US
Mailing Address - Phone:787-848-3873
Mailing Address - Fax:787-848-3873
Practice Address - Street 1:23 CAMPECHE STREET
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-848-3873
Practice Address - Fax:787-848-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0261120004Medicare ID - Type Unspecified