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General NPI Number Information
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NPI Number | 1669491684
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Entity Type | Organization
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Legal Business Name | MDME, INC
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | EXT SANTA TERESITA 3231 AVE EMILIO FAGOT
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City | PONCE
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State | PR
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Zip | 00730-4642
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Country | US
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Telephone | 787-984-0273
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Fax | 787-259-9109
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Provider Business Mailing Address
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Address Line | PO BOX 10059
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City | PONCE
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State | PR
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Zip | 00732-0059
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Country | US
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Telephone | 787-984-0273
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Fax | 787-259-9109
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARSENIA DOMINICCI
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Credential |
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Telephone | 787-984-0273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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