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Organization

MEDEXPRESS DIABETIC SUPPLY

Active
Other names
MEDSPR
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAFAEL ROSARIO PEGUERO (PROPIETARIO)
(787) 636-6496
Entity
Organization

Contact information

Practice address
324 CALLE PALACIOS, APT 4, SAN JUAN, PR 00915-2165
(787) 636-6496
Mailing address
324 CALLE PALACIOS, APT 4, SAN JUAN, PR 00915-2165
(787) 636-6496

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PR
332BC3200X
Customized Equipment (DME)
PR

Other

Enumeration date
08/07/2009
Last updated
08/07/2009
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