=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043257553
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTER ISLAND MEDICAL EQUIPMENT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 CALLE VIZCARRONDO
-----------------------------------------------------
City | AIBONITO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00705-3624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-735-8830
-----------------------------------------------------
Fax | 787-735-3141
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 CALLE VIZCARRONDO PO BOX 2049
-----------------------------------------------------
City | AIBONITO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00705-3624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-735-8830
-----------------------------------------------------
Fax | 787-735-3141
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. AWILDA TORRES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-735-8830
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------