Provider Demographics
NPI:1598837437
Name:EQUIPOMED CARE, CORP.
Entity Type:Organization
Organization Name:EQUIPOMED CARE, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-820-5553
Mailing Address - Street 1:P. O. BOX 1097
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-820-5553
Mailing Address - Fax:787-820-6851
Practice Address - Street 1:CARR. #2 KM 86.5
Practice Address - Street 2:BO. PUEBLO, CALLE MARGINAL
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-820-5553
Practice Address - Fax:787-820-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X, 332BC3200X, 332BX2000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5811330001Medicare NSC