Provider Demographics
NPI:1639198815
Name:HAMMOCKS MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:HAMMOCKS MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-764-8406
Mailing Address - Street 1:12-29 BOULEVARD DR
Mailing Address - Street 2:URB. SANTA ROSA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-6638
Mailing Address - Country:US
Mailing Address - Phone:787-764-8406
Mailing Address - Fax:787-765-2772
Practice Address - Street 1:12-29 BOULEVARD DR
Practice Address - Street 2:URB. SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6638
Practice Address - Country:US
Practice Address - Phone:787-764-8406
Practice Address - Fax:787-765-2772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5610220001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5610220001Medicare NSC