1861715302 NPI number — MEDICAL SERVICES SOLUTIONS EAI CORP

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 1861715302 NPI number — MEDICAL SERVICES SOLUTIONS EAI CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL SERVICES SOLUTIONS EAI CORP
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:
1861715302
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2055
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00751-2001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-669-5899
Provider Business Mailing Address Fax Number:
787-845-0458

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE CARACOL C8
Provider Second Line Business Practice Location Address:
URB VALLE COSTERO
Provider Business Practice Location Address City Name:
SANTA ISABEL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00757-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-669-5899
Provider Business Practice Location Address Fax Number:
787-845-0458
Provider Enumeration Date:
03/11/2010

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
ANAIDA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
SOCIAL WORKER/ CLINIC
Authorized Official Telephone Number:
787-669-5899

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  10178 , 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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