OrganizationMedical Domiciliary Services LlcGeneral PracticeAllopathic & Osteopathic PhysiciansPractice AddressCiudad Jardin De Gurabo Number 168 Calle Cundeamor, Gurabo, PR 00778(787) 627-0424PECOS EnrollmentBased on the most recent information from CMS, provider Medical Domiciliary Services Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1225372162Provider TypeOrganizationFull NameMedical Domiciliary Services LlcSubpartNoEnumeration Date11/15/2012Last Updated11/15/2012Contact InformationPractice LocationPractice AddressCiudad Jardin De Gurabo Number 168 Calle Cundeamor, Gurabo, PR 00778Phone(787) 627-0424FaxUnlisted FaxMailing LocationMailing AddressCiudad Jardin De Gurabo Number 168 Calle Cundeamor, Gurabo, PR 00778PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameLopez, Jorge (President)Phone(787) 627-0424Provider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer