Provider Demographics
NPI:1871756726
Name:LG MEDICAL
Entity type:Organization
Organization Name:LG MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-420-6479
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0309
Mailing Address - Country:US
Mailing Address - Phone:787-420-6479
Mailing Address - Fax:787-879-3279
Practice Address - Street 1:CALLE 2 A1
Practice Address - Street 2:URB VILLAS DE LOIZA
Practice Address - City:CANVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-420-6479
Practice Address - Fax:787-876-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies