1730322173 NPI number — DROMAYOR BOGOTA S.A

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 1730322173 NPI number — DROMAYOR BOGOTA S.A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DROMAYOR BOGOTA S.A
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:
6
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:
1730322173
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CLL 18 NO 68 D 72
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOGOTA D.C
Provider Business Mailing Address State Name:
CUNDINAMARCA
Provider Business Mailing Address Postal Code:
11001000
Provider Business Mailing Address Country Code:
CO
Provider Business Mailing Address Telephone Number:
571-294-8787
Provider Business Mailing Address Fax Number:
571-294-8787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 18 NO 68 D 72
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOGOTA D.C
Provider Business Practice Location Address State Name:
CUNDINAMARCA
Provider Business Practice Location Address Postal Code:
11001000
Provider Business Practice Location Address Country Code:
CO
Provider Business Practice Location Address Telephone Number:
571-294-8787
Provider Business Practice Location Address Fax Number:
571-294-8787
Provider Enumeration Date:
04/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
PORTELA
Authorized Official First Name:
RAFAEL
Authorized Official Middle Name:
FARAFAN
Authorized Official Title or Position:
GENERAL MANNAGER
Authorized Official Telephone Number:
571-294-8787

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  251B00000X , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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