1902825391 NPI number — TOA ALTA CURA CHC

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 1902825391 NPI number — TOA ALTA CURA CHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOA ALTA CURA CHC
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:
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:
1902825391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 CALLE BARCELO
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOA ALTA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00953-2444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-870-1529
Provider Business Mailing Address Fax Number:
787-870-1508

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 CALLE BARCELO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00953-2444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-870-1529
Provider Business Practice Location Address Fax Number:
787-870-1508
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VEGA
Authorized Official First Name:
EDITH
Authorized Official Middle Name:
M
Authorized Official Title or Position:
LABORATORY DIRECTOR
Authorized Official Telephone Number:
787-870-1529

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  0706 , 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: 31360 . This is a "TRIPLE S TRIPLE C" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: P848 . This is a "INTERNATIONAL MED CARD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3451-3 . This is a "ASOCIACION DE MAESTROS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4001281 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 00424 . This is a "AMERICAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 100167 . This is a "CRUZ AZUL DE PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 600293 . This is a "PREFERRED HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 0706 . This is a "STATE LABORATORY LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 61 . This is a "STATE HEALTH LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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