Provider Demographics
NPI:1972579415
Name:INTER MED SERVICE, INC
Entity type:Organization
Organization Name:INTER MED SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-894-2947
Mailing Address - Street 1:PO BOX 2006
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-2006
Mailing Address - Country:US
Mailing Address - Phone:787-894-2947
Mailing Address - Fax:787-894-2960
Practice Address - Street 1:31 CALLE DR CUETO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2887
Practice Address - Country:US
Practice Address - Phone:787-894-2947
Practice Address - Fax:787-894-2960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6116210001Medicare NSC