1356610554 NPI number — GOBIERNO MUNICIPAL GUAYAMA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356610554 NPI number — GOBIERNO MUNICIPAL GUAYAMA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOBIERNO MUNICIPAL GUAYAMA
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:
1356610554
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 360
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GUAYAMA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00784
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-864-0600
Provider Business Mailing Address Fax Number:
787-864-5070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA NUM 3 ESQUINA
Provider Second Line Business Practice Location Address:
CARRETERA MACHETE
Provider Business Practice Location Address City Name:
GUAYAMA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00784
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-864-0600
Provider Business Practice Location Address Fax Number:
787-866-6644
Provider Enumeration Date:
12/19/2011

Additional Information

Authorized Official

Authorized Official Last Name:
FRET
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
G
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-864-0600

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  TC AMB 679 , 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)





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