=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063830354
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARIAN MEDICAL EQUIPMENT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2014
-----------------------------------------------------
Last Update Date | 04/03/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | RD 859 KM 8 PADILLA WARD
-----------------------------------------------------
City | COROZAL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00783-7417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-859-7959
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 5 BOX 10126
-----------------------------------------------------
City | COROZAL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00783-7417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-859-7959
-----------------------------------------------------
Fax | 787-859-8128
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. FRANCISCO GONZALEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-644-7920
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 336692
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------