1821078882 NPI number — GENESIS ANESTHESIA SERVICES, PSC

Table of content: (NPI 1821078882)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821078882 NPI number — GENESIS ANESTHESIA SERVICES, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENESIS ANESTHESIA 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:
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:
1821078882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-6450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-805-1818
Provider Business Mailing Address Fax Number:
787-832-1585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL BELLA VISTA CARR 349 KM 2.7 CERRO LAS MESAS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-805-1818
Provider Business Practice Location Address Fax Number:
787-832-1585
Provider Enumeration Date:
01/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BAYRON-VELEZ
Authorized Official First Name:
ROBERTO
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-805-1818

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9242 . This is a "FIRST MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "HARVARD PILGRIM HEALTH CA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "ADVENTISTS RISK MANAGEMEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "HUMANA GOLD CLASSIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32516 . This is a "ASPCIACION DE MAESTROS DE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CHAMPUS/CHAMPVA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "AETNA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1696 . This is a "AMERICAN HEALTH INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61101 . This is a "HUMANA GOLD CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6810035 . This is a "HUMANA INSURANCE OF PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6810035 . This is a "HUMANA HEALTH OF PUERTO R" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "AARP" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "FIRST PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "COSVI" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CARE PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "AIG CLAIN SERVICES INC" identifier . This identifiers is of the category "OTHER".




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