Provider Demographics
NPI:1922019652
Name:OSCAR A. PABON RODRIGUEZ
Entity type:Organization
Organization Name:OSCAR A. PABON RODRIGUEZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PABON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-878-2915
Mailing Address - Street 1:PO BOX 607071
Mailing Address - Street 2:PMB 77
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7071
Mailing Address - Country:US
Mailing Address - Phone:787-878-2915
Mailing Address - Fax:787-878-2917
Practice Address - Street 1:AVE JOSE C BARBOSA # 58
Practice Address - Street 2:LOCAL B
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-2915
Practice Address - Fax:787-878-2917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4453440002Medicare NSC