1326170044 NPI number — MRS. MARIA ISABEL OLMEDA RG PH

Table of content: MRS. MARIA ISABEL OLMEDA RG PH (NPI 1326170044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326170044 NPI number — MRS. MARIA ISABEL OLMEDA RG PH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLMEDA
Provider First Name:
MARIA
Provider Middle Name:
ISABEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RG PH
Provider Gender Code:
F

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:
1326170044
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
A3 URB SANTA MARTA
Provider Second Line Business Mailing Address:
CALL BOX 5000 SUITE 77
Provider Business Mailing Address City Name:
SAN GERMAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00683-4402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-892-2058
Provider Business Mailing Address Fax Number:
787-892-2058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
A3 URB SANTA MARTA
Provider Second Line Business Practice Location Address:
CALL BOX 5000 SUITE 77
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683-4402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-892-2058
Provider Business Practice Location Address Fax Number:
787-892-2058
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  1884 , 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: 1884 . This is a "PHARMACIST PR LICENCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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