Healthcare Provider Details

I. General information

NPI: 1528166543
Provider Name (Legal Business Name): AMERICA MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 CALLE MATTEI LLUBERAS
YAUCO PR
00698-3635
US

IV. Provider business mailing address

PMB 307 CALL BOX 5004
YAUCO PR
00698-3635
US

V. Phone/Fax

Practice location:
  • Phone: 787-267-4006
  • Fax: 787-267-4006
Mailing address:
  • Phone: 787-267-4006
  • Fax: 787-267-4006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier50421
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerPMC MEDICARE CHOICE
# 2
Identifier480192
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerMMM
# 3
Identifier8242
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerAMERICAN HEALTH MEDICARE

VIII. Authorized Official

Name: CARLOS M. DEL VALLE
Title or Position: PRESIDENT
Credential:
Phone: 787-267-4006