Provider Demographics
NPI:1902897143
Name:HATO REY MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:HATO REY MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CONDE STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-274-8837
Mailing Address - Street 1:114 CALLE ELEANOR ROOSEVELT
Mailing Address - Street 2:URB. EL VEDADO - 1ST FLOOR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3105
Mailing Address - Country:US
Mailing Address - Phone:787-274-8837
Mailing Address - Fax:
Practice Address - Street 1:114 CALLE ELEANOR ROOSEVELT
Practice Address - Street 2:URB. EL VEDADO - 1ST FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3105
Practice Address - Country:US
Practice Address - Phone:787-274-8837
Practice Address - Fax:787-753-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRAPM153332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1019920001Medicare UPIN