1093014474 NPI number — BABY BAMS CORP

Table of content: (NPI 1093014474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093014474 NPI number — BABY BAMS CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BABY BAMS CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093014474
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RIVER VALLEY PARK TALLABOA ST. 113
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANOVANAS
Provider Business Mailing Address State Name:
PUERTO RICO
Provider Business Mailing Address Postal Code:
00729
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
787-585-4445
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RIVER VALLEY PARK TALLABOA ST. 113
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANOVANAS
Provider Business Practice Location Address State Name:
PUERTO RICO
Provider Business Practice Location Address Postal Code:
00729
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
787-585-4445
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
PAOLA
Authorized Official Middle Name:
ISABEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-585-4445

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  04608890018 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)