Provider Demographics
NPI:1609177146
Name:BARD SHANNON LIMITED
Entity Type:Organization
Organization Name:BARD SHANNON LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SALES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-238-1017
Mailing Address - Street 1:17 CALLE 2 STE 620
Mailing Address - Street 2:METRO OFFICE PARK
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-1787
Mailing Address - Country:US
Mailing Address - Phone:787-238-1017
Mailing Address - Fax:787-804-1533
Practice Address - Street 1:17 CALLE 2 STE 620
Practice Address - Street 2:METRO OFFICE PARK
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-1787
Practice Address - Country:US
Practice Address - Phone:787-238-1017
Practice Address - Fax:787-804-1533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier