1750484135 NPI number — LABORATORIO CLINICO BEAUCHAMP

Table of content: (NPI 1750484135)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750484135 NPI number — LABORATORIO CLINICO BEAUCHAMP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO BEAUCHAMP
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:
1750484135
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 DR VAZQUEZ COLON
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORIDA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-822-3364
Provider Business Mailing Address Fax Number:
787-822-3364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 DR VAZQUEZ COLON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORIDA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-822-3364
Provider Business Practice Location Address Fax Number:
787-822-3364
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BEAUCHAMP
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-822-0081

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  831 , 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: 011831 . This is a "GLOBAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 051580 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584683972 . This is a "HAPFRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584683972 . This is a "MMM MCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 950 . This is a "APS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20042 . This is a "AMERICAN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21723 . This is a "AHPR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584683972 . This is a "MMM COSVI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20012 . This is a "MMMPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584683972 . This is a "CORVI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6500008 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 800084 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1126 . This is a "IMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400367 . This is a "UTI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584683972 . This is a "MCS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6006523 . This is a "ACAA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30827 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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