1649560111 NPI number — CORRECTIONAL HEALTH SERVICES CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649560111 NPI number — CORRECTIONAL HEALTH SERVICES CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORRECTIONAL HEALTH SERVICES 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:
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:
1649560111
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE 1 LOTE 18
Provider Second Line Business Mailing Address:
SUITE 400 METRO OFFICE PARK
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00968-1768
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-774-3344
Provider Business Mailing Address Fax Number:
787-774-6253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE 1 LOTE 18
Provider Second Line Business Practice Location Address:
SUITE 400 METRO OFFICE PARK
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00968-1768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-774-3344
Provider Business Practice Location Address Fax Number:
787-774-6253
Provider Enumeration Date:
04/18/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RESTO
Authorized Official First Name:
BILL
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
787-774-3344

Provider Taxonomy Codes

  • Taxonomy code: 261QP2400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 283Q00000X , with the licence number: 10-CNCNUM.05-298 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 313M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X , 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)