Provider Demographics
NPI:1649370404
Name:TOTAL VICTORY SALES AND RENTAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:TOTAL VICTORY SALES AND RENTAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-793-7160
Mailing Address - Street 1:1353 SAN ALFONSO AVE.
Mailing Address - Street 2:URB. ALTAMESA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-793-7160
Mailing Address - Fax:787-273-6010
Practice Address - Street 1:CALL BOX 7887
Practice Address - Street 2:PMB 134
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970-7887
Practice Address - Country:US
Practice Address - Phone:787-793-7160
Practice Address - Fax:787-273-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1226332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies