1790810182 NPI number — HEALTH LABORATORIES SERVICES INC

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 1790810182 NPI number — HEALTH LABORATORIES SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH LABORATORIES SERVICES 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:
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:
1790810182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-3310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-762-4786
Provider Business Mailing Address Fax Number:
787-752-3360

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PLAZA SAN MIGUEL LOCAL 203 2DO PISO
Provider Second Line Business Practice Location Address:
EXPRESO TRUJILLO ALTO KM. 4.4
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-283-3881
Provider Business Practice Location Address Fax Number:
787-283-3881
Provider Enumeration Date:
02/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ DE VICTORIA
Authorized Official First Name:
MYRTA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-762-4786

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  1024 , 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: 660487506 . This is a "COSVI MED PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8462 . This is a "IMC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: LA-0519 . This is a "PALIC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 048755405 . This is a "COSVI PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20097 . This is a "AMERICAN HEALTH PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20115D . This is a "PMC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 052230 . This is a "CRUZ AZUL PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 400474 . This is a "UTI PREFERRED PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 40411 . This is a "MCS EXCLUSIVE PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30932SA . This is a "TRIPLE S PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 800062 . This is a "MMM HEALTHCARE PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 9760037 . This is a "HUMANA PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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