Provider Demographics
NPI:1801841291
Name:MASTER MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:MASTER MEDICAL SUPPLY INC
Other - Org Name:SHEILA I NEGRETTI ALVAREZ
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:I
Authorized Official - Last Name:NEGRETTI
Authorized Official - Suffix:
Authorized Official - Credentials:BBA
Authorized Official - Phone:787-779-5197
Mailing Address - Street 1:PO BOX 2400
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951-2400
Mailing Address - Country:US
Mailing Address - Phone:787-779-5197
Mailing Address - Fax:787-779-4188
Practice Address - Street 1:EXTENSION VILLA RICA H26 CALLE 2
Practice Address - Street 2:STE A
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-779-5197
Practice Address - Fax:787-779-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0792254332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4270990001Medicare NSC