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General NPI Number Information
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NPI Number | 1366708679
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Entity Type | Organization
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Legal Business Name | PRPR-MED, CORP.
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | ROAD PR 115 KM 20.1 INTERIOR
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City | AGUADA
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State | PR
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Zip | 00602-3119
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Country | US
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Telephone | 787-607-1408
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Fax | 877-360-8910
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Provider Business Mailing Address
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Address Line | 29 URB LOS FLAMBOYANES
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City | AGUADA
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State | PR
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Zip | 00602-3119
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Country | US
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Telephone | 787-607-1408
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Fax | 877-360-8910
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MR. EDGAR A. SANCHEZ RIVERA
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Credential |
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Telephone | 787-607-1408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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