1598769861 NPI number — LABORATORIO CLINICO LOIZA VALLEY INC.

Table of content: (NPI 1487184990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598769861 NPI number — LABORATORIO CLINICO LOIZA VALLEY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO LOIZA VALLEY 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:
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:
1598769861
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 937
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANOVANAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00729-0937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-876-0430
Provider Business Mailing Address Fax Number:
787-256-1836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LOIZA VALLEY MALL
Provider Second Line Business Practice Location Address:
BAUHINIA Z-977
Provider Business Practice Location Address City Name:
CANOVANAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-876-0430
Provider Business Practice Location Address Fax Number:
787-256-1836
Provider Enumeration Date:
06/02/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SALICRUP
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
MILAGROS
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-876-0430

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  694 , 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: 400111 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 00694 . This is a "GLOBAL HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 051290 . This is a "LA CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20401 . This is a "AMERICAN HEALTH INC." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30568 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1424-3 . This is a "ASOCIACION DE MAESTROS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30568 . This is a "TRIPLE SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6004296 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".