Organization
SABANA GRANDE MEDICAL SUPPLY
Active
Other names
Edwin Matos Velez
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN MATOS (OWNER)
(787) 804-0268
Entity
Organization
Contact information
Practice address
50 AVE LIBORIO LOPEZ, SABANA GRANDE, PR 00637-2032
(787) 804-0268
(787) 804-0268
Mailing address
50 AVE LIBORIO LOPEZ, SABANA GRANDE, PR 00637-2032
(787) 804-0268
(787) 804-0268
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
IN-PROCESS
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
467582
JOINT COMMISSION ORGANIZATION ID
PR
Enumeration date
10/06/2009
Last updated
10/06/2009
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