1407823800 NPI number — GIACRIMAR CORP

Table of content: (NPI 1407823800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407823800 NPI number — GIACRIMAR CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GIACRIMAR 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:
LABORATORIO CLINICO ROMAN
Provider Other Organization Name Type Code:
3
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:
1407823800
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1554
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00613-1554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-878-4670
Provider Business Mailing Address Fax Number:
787-816-6948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 AVE JOSE DE DIEGO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-4585
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-4670
Provider Business Practice Location Address Fax Number:
787-816-6948
Provider Enumeration Date:
03/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
CARLOS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-878-4670

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  443 , 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)





Copyright © 2007-2024 www.npivalidator.com