1538534227 NPI number — RISO MEDICAL SERVICES, LLC

Table of content: (NPI 1538534227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538534227 NPI number — RISO MEDICAL SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RISO MEDICAL SERVICES, LLC
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:
1538534227
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE HUCARES 43
Provider Second Line Business Mailing Address:
URB VILLA LUCIA
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-908-0834
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ZONA INDUSTRIAL VICTOR ROJAS 2
Provider Second Line Business Practice Location Address:
CARR 129
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-908-0834
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RIVERO
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
716-908-0834

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  18790 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207UN0902X , with the licence number: 18790 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: 17234 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)