MEDICARE: BIO-MEDICAL APPLICATIONS OF PUERTO RICO, 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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255509048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIO-MEDICAL APPLICATIONS OF PUERTO RICO, INC.

Provider Business Mailing Address
First Line	:	ROAD #3, KM. 19.9
Second Line	:	CANOVANAS WARD
City	:	CANOVANAS
State	:	PR
Zip	:	00729-0000
Country	:	US
Telephone Number	:	787-957-9647
Fax Number	:	787-256-1010

Provider Business Practice Location Address
First Line	:	ROAD #3, KM. 19.9
Second Line	:	CANOVANAS WARD
City	:	CANOVANAS
State	:	PR
Zip	:	00729-0000
Country	:	US
Telephone Number	:	787-957-9647
Fax Number	:	787-256-1010

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BARRY L. BLANTON
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	10/16/2023

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