MEDICARE: MONSERRATE SALES AND RENTAL EQUIPMENT INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	335E00000X	Prosthetic/Orthotic Supplier
4	332BX2000X	Oxygen Equipment & Supplies (DME)	05-P-1761	PR

General Provider Information

NPI Number	:	1033103163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONSERRATE SALES AND RENTAL EQUIPMENT INC.

Provider Business Mailing Address
First Line	:	PO BOX 366148
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-6148
Country	:	US
Telephone Number	:	787-754-0449
Fax Number	:	787-751-4204

Provider Business Practice Location Address
First Line	:	1517 CALLE PARANA
Second Line	:	URB. EL PARAISO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2814
Country	:	US
Telephone Number	:	787-754-0449
Fax Number	:	787-751-4204

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUIS V CLAS
Credential	:
Telephone Number	:	787-754-0449

Provider Enumeration Date	:	09/03/2005
Last Update Date	:	12/14/2011

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