1831234301 NPI number — PEDIATRIC HOME CARE SERVICES, INC.

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 1831234301 NPI number — PEDIATRIC HOME CARE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEDIATRIC HOME CARE 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:
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:
1831234301
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1502 CALLE BORI
Provider Second Line Business Mailing Address:
URB ANTONSANTTI
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-789-6712
Provider Business Mailing Address Fax Number:
787-200-6712

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
E1 CALLE GARFIELD
Provider Second Line Business Practice Location Address:
URB PARKVILLE SUR
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969-4415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-789-6712
Provider Business Practice Location Address Fax Number:
787-789-6712
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VALENTIN
Authorized Official First Name:
IRVIN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-242-8990

Provider Taxonomy Codes

  • Taxonomy code: 3140N1450X , with the licence number:  52 , 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)





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