Provider Demographics
NPI:1750478905
Name:ATENAS MEDICAL SUPPLY CORP
Entity Type:Organization
Organization Name:ATENAS MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RMO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTO
Authorized Official - Middle Name:P
Authorized Official - Last Name:VAZQUEZ-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-846-5919
Mailing Address - Street 1:10 URB ZENO
Mailing Address - Street 2:PO BOX 610
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-3327
Mailing Address - Country:US
Mailing Address - Phone:787-846-5919
Mailing Address - Fax:787-846-6186
Practice Address - Street 1:10 URB ZENO
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-3327
Practice Address - Country:US
Practice Address - Phone:787-846-5919
Practice Address - Fax:787-846-6186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies