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General NPI Number Information
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NPI Number | 1730179185
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Entity Type | Organization
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Legal Business Name | DIABETIC CENTER & HOSPITAL SUPPLY INC
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 10/08/2011
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Provider Practice Location Address
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Address Line | 2743 CALLE LAS CARROZAS URB PERLA DEL SUR
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City | PONCE
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State | PR
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Zip | 00717-0407
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Country | US
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Telephone | 787-284-3997
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Fax | 787-843-0014
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Provider Business Mailing Address
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Address Line | PO BOX 8746
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City | PONCE
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State | PR
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Zip | 00732-8746
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Country | US
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Telephone | 787-284-3997
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Fax | 787-284-3997
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAMON BONILLA
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Credential |
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Telephone | 787-284-3997
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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 | DI0300C
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License Number State | PR
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