1487907457 NPI number — NUEVA VIDA ELDERLY INC.

Table of content: (NPI 1487907457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487907457 NPI number — NUEVA VIDA ELDERLY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NUEVA VIDA ELDERLY 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:
MEDTRANSPORT
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:
1487907457
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. MONACO 1
Provider Second Line Business Mailing Address:
STREET 4 G-22
Provider Business Mailing Address City Name:
MANATI
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00674
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-512-2001
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SECTOR LOS RABANOS
Provider Second Line Business Practice Location Address:
CARR 604 KM 2.5
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-436-6646
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
SARA
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
787-436-6646

Provider Taxonomy Codes

  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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