1972639664 NPI number — MED CARE HEALTH, INC.

Table of content: KARISSA NICOLE LOVE JOHNSON (NPI 1295523306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972639664 NPI number — MED CARE HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MED CARE HEALTH, 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:
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:
1972639664
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1074
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698-1074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-856-4700
Provider Business Mailing Address Fax Number:
787-856-7900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR.121 KM 12.9 SUSUA BAJA SECTOR GEMINIS
Provider Second Line Business Practice Location Address:
CALLE PROFESORA ZENAIDA ORTIZ #1
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698-2154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-856-4700
Provider Business Practice Location Address Fax Number:
787-856-7900
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-856-4700

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , 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)





Copyright © 2007-2025 www.npivalidator.com