Mediwest Specialty Distribution LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MEDIWEST SPECIALTY DISTRIBUTION LLC

Practice address

Hormigueros Office Park Petrowest Plaza
Carr 345 KM 1.5
Hormigueros, PR 00660

Phone

(787) 248-4144

Fax

(787) 966-7303

NPI assigned

May 11, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ibsen Torres

Title

President

Phone

(787) 376-4665

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555977600000",
    "number": "1528594348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3795",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006813795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HORMIGUEROS OFFICE PARK PETROWEST PLAZA",
            "address_2": "CARR 345 KM 1.5",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "00660",
            "telephone_number": "787-248-4144",
            "fax_number": "787-966-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIWEST SPECIALTY DISTRIBUTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2019-04-23",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "IBSEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-376-4665"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jose Gerardo Melendez-Negron, OD
• Juan E Mendez Servera, MD
• Rafael Mendoza-Irizarry, M.D.
• Angelivette Mercado Munoz, MA
• Metro Pavia at Home, LLC (Metro Pavia @ Home- Mayaguez)

• Prosthetic/Orthotic Supplier in Hormigueros, PR
• Providers in Hormigueros, PR by specialty
• Prosthetic/Orthotic Supplier in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.