| NPI | 1467632174 |
|---|---|
| Former Legal Business Name | PUERTA DE LUZ MEDICAL SUPPLIES |
| Entity Type | Organization |
| Authorized Contact | MELVIN SANTIAGO President 978-884-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA s30116967) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2008-08-21 |