Organization
PUERTA DE LUZ MEDICAL SUPPLIES INC
Active
Other names
PUERTA DE LUZ MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN SANTIAGO (PRESIDENT)
(978) 884-5523
Entity
Organization
Contact information
Practice address
114 HANCOCK ST # A, LAWRENCE, MA 01841-5055
(978) 884-5523
(978) 655-1733
Mailing address
PO BOX 636, METHUEN, MA 01844
(978) 884-5523
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
S30116967
MA
Other
Enumeration date
11/09/2007
Last updated
08/21/2008
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