Provider Demographics
NPI:1902071681
Name:RAG MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:RAG MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GULICK
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-206-0835
Mailing Address - Street 1:355 AVE GEN VALERO
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4843
Mailing Address - Country:US
Mailing Address - Phone:787-206-0835
Mailing Address - Fax:787-860-7272
Practice Address - Street 1:355 AVE GEN VALERO
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4843
Practice Address - Country:US
Practice Address - Phone:787-863-7189
Practice Address - Fax:787-860-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies