1992776587 NPI number — RG ENTERPRISES INC

Table of content: (NPI 1992776587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992776587 NPI number — RG ENTERPRISES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RG ENTERPRISES INC
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:
WILFREDO REYES
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:
1992776587
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3386
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-3386
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-785-3850
Provider Business Mailing Address Fax Number:
787-785-3850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE ISABEL II, PRIMER NIVEL
Provider Second Line Business Practice Location Address:
EDIF. JOAQUIN MONTASINOS
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-785-3850
Provider Business Practice Location Address Fax Number:
787-785-3850
Provider Enumeration Date:
01/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRAJALES
Authorized Official First Name:
MARITZA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-667-1902

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  203 , 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)

  • Identifier: 400137 . This is a "UTI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 800009 . This is a "MEDICARE Y MUCHO MAS-MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "COSVI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "FIRST PLUS MEDICARE ADVAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20409 . This is a "PREFFERED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "MCS & MCS CLASSICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 011203LI . This is a "GLOBAL HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 31438 . This is a "SSS OPTIMO & SSS REFORMA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "CIGNA & CIGNA EXCLUSIVE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 100620 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "MAPFRE & MAPFRE MEDICARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 31438AS . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8753 . This is a "AMERICAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "OPTION HEALTHCARE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9840027 . This is a "HUMANA & HUMANA REFORMA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: LA0620 . This is a "PALIC- PANAMERICAN LIFE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: A165 . This is a "FIRST MEDICAL- I.M.C." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: ITIN . This is a "MEDPLUS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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