Organization
FOUR GRAINS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN RODRIGUEZ (PRESIDENT)
(787) 516-1045
Entity
Organization
Contact information
Practice address
CARR. 723 KM 0.8, BO. ASOMANTE, AIBONITO, PR 00705
(939) 425-0052
Mailing address
1000 AVE JOSE ZAYAS GRN APT D3, BARRANQUITAS, PR 00794-2031
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
03/12/2025
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