Provider Demographics
NPI:1861480089
Name:PROJECT MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:PROJECT MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-841-6883
Mailing Address - Street 1:1575 AVE MUNOZ RIVERA
Mailing Address - Street 2:STE 140
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-841-6883
Mailing Address - Fax:787-284-0727
Practice Address - Street 1:1279 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-9999
Practice Address - Country:US
Practice Address - Phone:787-841-6883
Practice Address - Fax:787-284-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPR1500C332B00000X
PR05-P-1500332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR990541OtherMMM HEALTH CARE
PR55210PROtherTRIPLE S
PRX9905OtherCRUZ AZUL DE PR
PR1190340001Medicare NSC