1386608057 NPI number — LABORATORIO CLINICO RAMVAD INC

Table of content: (NPI 1386608057)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386608057 NPI number — LABORATORIO CLINICO RAMVAD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO RAMVAD 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:
1386608057
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
716 AVENIDA PONCE DE LEON
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
HATO REY
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00918-4510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-758-7120
Provider Business Mailing Address Fax Number:
787-758-7120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
716 AVENIDA PONCE DE LEON
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
HATO REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-4510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-7120
Provider Business Practice Location Address Fax Number:
787-758-7120
Provider Enumeration Date:
04/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VALDES-PLAZA
Authorized Official First Name:
NILDA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-758-7120

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  0338 , 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: 5146 . This is a "FIRST MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050433 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31057RA . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6001378 . This is a "ACAA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9180044 . This is a "HUMANA HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9180044 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: LA0050 . This is a "PALIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400017 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".




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