1861988982 NPI number — BEST LAB

Table of content: (NPI 1861988982)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861988982 NPI number — BEST LAB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST LAB
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:
1861988982
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HIDALGO 248 A
Provider Second Line Business Mailing Address:
SAN ANTONIO TLAYACAPAN
Provider Business Mailing Address City Name:
CHAPALA
Provider Business Mailing Address State Name:
JALISCO
Provider Business Mailing Address Postal Code:
45906
Provider Business Mailing Address Country Code:
MX
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HIDALGO 248 A
Provider Second Line Business Practice Location Address:
SAN ANTONIO TLAYACAPAN
Provider Business Practice Location Address City Name:
CHAPALA
Provider Business Practice Location Address State Name:
JALISCO
Provider Business Practice Location Address Postal Code:
45906
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
888-449-7799
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2018

Additional Information

Authorized Official

Authorized Official Last Name:
SEPULVEDA
Authorized Official First Name:
FRANCISCO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
888-449-7799

Provider Taxonomy Codes

  • Taxonomy code: 246RM2200X , with the licence number:  CP4876548 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4876548 . This is a "GOVERMENT" identifier . This identifiers is of the category "OTHER".




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