1588709661 NPI number — R & V VISION SERVICES PSC

Table of content: (NPI 1588709661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588709661 NPI number — R & V VISION SERVICES PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R & V VISION SERVICES PSC
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:
BETTER VISION
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:
1588709661
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SAN LORENZO SHOPPING CTR
Provider Second Line Business Mailing Address:
SUITE 12 B CARR 183 KM 1 1
Provider Business Mailing Address City Name:
SAN LORENZO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00754-4534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-715-3744
Provider Business Mailing Address Fax Number:
787-715-3745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SAN LORENZO SHOPPING CTR
Provider Second Line Business Practice Location Address:
SUITE 12 B CARR 183 KM 1 1
Provider Business Practice Location Address City Name:
SAN LORENZO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00754-4534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-715-3744
Provider Business Practice Location Address Fax Number:
787-715-3745
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VAZQUEZ
Authorized Official First Name:
NILDA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-715-3744

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  462 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: 457 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 07540051 . This is a "HUMANA HEALTH PLANS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 0077162 . This is a "LA CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 04140 . This is a "AMERICAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 215131 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 34255 . This is a "PROSSAM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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