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General NPI Number Information
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NPI Number | 1821080581
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Entity Type | Organization
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Legal Business Name | MANGUAL & MENCHACA, INC.
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | NOYA & HERNANDEZ # 2
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-852-4180
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Fax | 787-285-4055
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Provider Business Mailing Address
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Address Line | PO BOX 8567
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City | HUMACAO
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State | PR
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Zip | 00792-8567
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Country | US
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Telephone | 787-852-4180
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Fax | 787-285-4055
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARISEL MENCHACA
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Credential |
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Telephone | 787-852-4180
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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 |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 07-F-1209
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License Number State | PR
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