Provider Demographics
NPI:1720089717
Name:CONDADO SALES AND RENTAL, INC
Entity type:Organization
Organization Name:CONDADO SALES AND RENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARIA DE
Authorized Official - Middle Name:LOURDES
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:787-758-2325
Mailing Address - Street 1:186 CALLE JUAN P DUARTE
Mailing Address - Street 2:FLORAL PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3602
Mailing Address - Country:US
Mailing Address - Phone:787-758-2325
Mailing Address - Fax:787-765-9876
Practice Address - Street 1:186 CALLE JUAN P DUARTE
Practice Address - Street 2:FLORAL PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3602
Practice Address - Country:US
Practice Address - Phone:787-758-2325
Practice Address - Fax:787-765-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4821320001Medicare NSC