MEDICARE: CALEB MEDICAL SUPPLIES, 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

General Provider Information

NPI Number	:	1265462964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALEB MEDICAL SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 14037
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00916-4037
Country	:	US
Telephone Number	:	787-796-5944
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE MENDEZ VIGO # 261
Second Line	:
City	:	DORADO
State	:	PR
Zip	:	00646-4924
Country	:	US
Telephone Number	:	787-796-5944
Fax Number	:	787-796-2215

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CALEB NEIRA
Credential	:
Telephone Number	:	787-796-5944

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	05/14/2009

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