1326497702 NPI number — TU NUTRICION CORPORATION

Table of content: (NPI 1326497702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326497702 NPI number — TU NUTRICION CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TU NUTRICION CORPORATION
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:
1326497702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
138 AVE WINSTON CHURCHILL
Provider Second Line Business Mailing Address:
PMB 323
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-396-1916
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 CALLE ATENAS
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926-7807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-396-1916
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MUNOZ
Authorized Official First Name:
CRISTINA
Authorized Official Middle Name:
BEATRIZ
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-396-1916

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  1457 , 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: 1457 . This is a "DEPARTMENT OF HEALTH OF PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com