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General NPI Number Information
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NPI Number | 1326346206
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Entity Type | Organization
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Legal Business Name | PJ MEDICAL SUPPLIES AND PROSTHETICS CORP
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 1418 AVE AMERICO MIRANDA URB CAPARRA TERRACE
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City | SAN JUAN
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State | PR
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Zip | 00921-2128
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Country | US
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Telephone | 787-782-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 1418 AVE AMERICO MIRANDA URB CAPARRA TERRACE
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City | SAN JUAN
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State | PR
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Zip | 00921-2128
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Country | US
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Telephone | 787-782-2866
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JORGE R SERRAT
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Credential |
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Telephone | 787-782-2866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | PR
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