Provider Demographics
NPI:1689781700
Name:EL SALVADOR MEDICAL AND HOMECARE EQUIPMENT, INC.
Entity Type:Organization
Organization Name:EL SALVADOR MEDICAL AND HOMECARE EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:GERARDO
Authorized Official - Last Name:REYES-ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-807-1111
Mailing Address - Street 1:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-1450
Mailing Address - Country:US
Mailing Address - Phone:787-807-1111
Mailing Address - Fax:787-807-1111
Practice Address - Street 1:PLAZA JARDINES SUITE 7
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-807-1111
Practice Address - Fax:787-807-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08P2350332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6187OtherAMERICAN HEALTH MEDICARE
PR6187OtherAMERICAN HEALTH MEDICARE