1609026293 NPI number — SOUTH CARIBBEAN LABORATORY CORP

Table of content: (NPI 1609026293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609026293 NPI number — SOUTH CARIBBEAN LABORATORY CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH CARIBBEAN LABORATORY CORP
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:
6
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:
1609026293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
QUINTAS DE MONSERRATE CALLE 2 D-7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-486-4554
Provider Business Mailing Address Fax Number:
787-259-5852

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 2 KM 225.8
Provider Second Line Business Practice Location Address:
LOCAL 26B
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-486-4554
Provider Business Practice Location Address Fax Number:
787-843-9000
Provider Enumeration Date:
09/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
COLON
Authorized Official First Name:
CARLOS
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-486-4554

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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