Provider Demographics
NPI:1457343238
Name:NUTRITION CARE, INC.
Entity Type:Organization
Organization Name:NUTRITION CARE, INC.
Other - Org Name:HATO REY MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-778-5449
Mailing Address - Street 1:114 CALLE ELEANOR ROOSEVELT,
Mailing Address - Street 2:URB. EL VEDADO, 1ST FLOOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3105
Mailing Address - Country:US
Mailing Address - Phone:787-778-5449
Mailing Address - Fax:787-780-7475
Practice Address - Street 1:114 CALLE ELEANOR ROOSEVELT
Practice Address - Street 2:URB. EL VEDADO, 1ST FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3105
Practice Address - Country:US
Practice Address - Phone:787-778-5449
Practice Address - Fax:787-780-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1252490001332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9500048OtherHUMANA
PR50200OtherPREFERRED MEDICARE CHOICE
PR9000115OtherCRUZ AZUL
PR55273OtherTRIPLE S, INC.
PR991269OtherMEDICARE MUCHO MAS (MMM)
PR50200OtherPREFERRED MEDICARE CHOICE
PR9000115OtherCRUZ AZUL
PR=========OtherMAPFRE LIFE INSURANCE