Provider Demographics
NPI:1114267127
Name:AXISCARE HEALTH LOGISTICS INC
Entity type:Organization
Organization Name:AXISCARE HEALTH LOGISTICS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:ISMARO
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-251-2323
Mailing Address - Street 1:PO BOX 1366
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-1366
Mailing Address - Country:US
Mailing Address - Phone:787-251-2323
Mailing Address - Fax:787-644-1299
Practice Address - Street 1:CARR 2 KM 19.5 PEPSI INDUSTRIAL PARK # 1
Practice Address - Street 2:CANDELARIA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-251-2323
Practice Address - Fax:787-251-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4916260001Medicare NSC