1891820288 NPI number — HEALTH LABORATORIES SERVICES INC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891820288 NPI number — HEALTH LABORATORIES SERVICES INC

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 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:

1891820288

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

08/06/2010

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

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 First Line Business Practice Location Address:

AVENIDA MONSERRATE BH-13

Provider Second Line Business Practice Location Address:

VALLE ARRIBA HEIGHTS

Provider Business Practice Location Address City Name:

CAROLINA

Provider Business Practice Location Address State Name:

PR

Provider Business Practice Location Address Postal Code:

00985

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

787-752-1105

Provider Business Practice Location Address Fax Number:

787-752-1165

Provider Enumeration Date:

02/23/2007

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

• Taxonomy code: 291U00000X , with the licence number:  313 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 052096 . This is a "CRUZ AZUL PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 30824VA . This is a "TRIPLE S PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 660487503 . 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: 04875544 . This is a "COSVI PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 20115C . This is a "PMC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 9850012 . This is a "HUMANA PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 20096 . This is a "AMERICAN HEALTH PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 800070 . This is a "MMM HEALTHCARE PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 400263 . This is a "UTI PREFERRED PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: L-0010 . This is a "PALIC PROV #" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".