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General NPI Number Information
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NPI Number | 1588844997
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Entity Type | Organization
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Legal Business Name | GOLDEN MEDICAL SUPPLY
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 65 DE INFANTERIA #67 SUITE B201
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-826-0932
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Fax | 787-826-6082
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Provider Business Mailing Address
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Address Line | PO BOX 84
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City | ANASCO
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State | PR
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Zip | 00610-0084
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Country | US
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Telephone | 787-826-0932
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Fax | 787-826-6082
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Authorized Official
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Title or Position | OWNER
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Name | CARLOS FRANCIS RIVERA
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Credential |
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Telephone | 787-826-0932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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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 | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 08P1621
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License Number State | PR
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Taxonomy #3
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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 | PR
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