MEDICARE: HEALTHCARE PROVIDER 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		PR

General Provider Information

NPI Number	:	1609879857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE PROVIDER INC.

Provider Business Mailing Address
First Line	:	PO BOX 362186
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-2186
Country	:	US
Telephone Number	:	787-274-8110
Fax Number	:	787-274-8123

Provider Business Practice Location Address
First Line	:	171 AVE WINSTON CHURCHILL
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6012
Country	:	US
Telephone Number	:	787-274-8110
Fax Number	:	787-274-8123

Authorized Official
Title or Position	:	VP.
Name	:	KELVIN TORRES
Credential	:
Telephone Number	:	787-630-1403

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/21/2022

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