1497258339 NPI number — CMT GROUP, CORP

Table of content: (NPI 1497258339)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497258339 NPI number — CMT GROUP, CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CMT GROUP, 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:
CMT GROUP - RADIOLOGY SERVICES
Provider Other Organization Name Type Code:
5
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:
1497258339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 51502
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00950-1502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-754-6868
Provider Business Mailing Address Fax Number:
787-274-9280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB UNIVERSITY GARDENS
Provider Second Line Business Practice Location Address:
300 CALLE CLEMSON
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-754-6868
Provider Business Practice Location Address Fax Number:
787-274-9280
Provider Enumeration Date:
03/16/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CABRERA
Authorized Official First Name:
XIOMARA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-754-6868

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  133368 , 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: 133368 . This is a "DEPT SALUD - SALUD AMBIENTAL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com