1134543135 NPI number — ADVANCED HEALTH SOLUTIONS PSC

Table of content: DR. DONALD RUSSELL MERRYFIELD DDS (NPI 1689879603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134543135 NPI number — ADVANCED HEALTH SOLUTIONS PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED HEALTH SOLUTIONS 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:
1134543135
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3214 CALLE RIO GUAYABO
Provider Second Line Business Mailing Address:
PRADERA DEL RIO
Provider Business Mailing Address City Name:
TOA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00953-9123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-797-3057
Provider Business Mailing Address Fax Number:
787-946-7775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 12 RR-1 OFICINA 101
Provider Second Line Business Practice Location Address:
CANA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-946-7799
Provider Business Practice Location Address Fax Number:
787-946-7775
Provider Enumeration Date:
02/11/2014

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES
Authorized Official First Name:
BELKLIZ
Authorized Official Middle Name:
YANIRA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-946-7799

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  14893 , 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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