Provider Demographics
NPI:1336171834
Name:RIVERA MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:RIVERA MEDICAL EQUIPMENT, INC.
Other - Org Name:RC MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-879-2806
Mailing Address - Street 1:HC-03 BOX 22231
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9171
Mailing Address - Country:US
Mailing Address - Phone:787-879-2806
Mailing Address - Fax:787-879-2806
Practice Address - Street 1:BODOMINGUITO SECTOR 4 CALLES ROAD 635 KM 2.2
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9171
Practice Address - Country:US
Practice Address - Phone:787-879-2806
Practice Address - Fax:787-879-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR64785332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0984210001Medicare NSC