1790810182 NPI number — HEALTH LABORATORIES SERVICES INC

Table of content: (NPI 1790810182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790810182 NPI number — HEALTH LABORATORIES SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH LABORATORIES SERVICES 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:
LABORATORIO CLINICO SAN MIGUEL
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:
1790810182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-3310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-762-4786
Provider Business Mailing Address Fax Number:
787-752-3360

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PLAZA SAN MIGUEL LOCAL 203 2DO PISO
Provider Second Line Business Practice Location Address:
EXPRESO TRUJILLO ALTO KM. 4.4
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-283-3881
Provider Business Practice Location Address Fax Number:
787-283-3881
Provider Enumeration Date:
02/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ DE VICTORIA
Authorized Official First Name:
MYRTA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-762-4786

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  1024 , 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: 660487506 . This is a "COSVI MED PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8462 . This is a "IMC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: LA-0519 . This is a "PALIC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 048755405 . This is a "COSVI PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20097 . This is a "AMERICAN HEALTH PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20115D . This is a "PMC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 052230 . This is a "CRUZ AZUL PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 400474 . This is a "UTI PREFERRED PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40411 . This is a "MCS EXCLUSIVE PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30932SA . This is a "TRIPLE S PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 800062 . This is a "MMM HEALTHCARE PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9760037 . This is a "HUMANA PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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