1972754604 NPI number — EMPRESAS COLON AYALA INC

Table of content: (NPI 1972754604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972754604 NPI number — EMPRESAS COLON AYALA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMPRESAS COLON AYALA 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:
1972754604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3843
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-3843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-662-2232
Provider Business Mailing Address Fax Number:
787-834-0047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ROAD 102 KM 18.8
Provider Second Line Business Practice Location Address:
LIGHTHOUSE PLAZA HOTE - SUITE 104
Provider Business Practice Location Address City Name:
CABO ROJO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-662-2232
Provider Business Practice Location Address Fax Number:
787-851-4343
Provider Enumeration Date:
09/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
AYALA-SANTIAGO
Authorized Official First Name:
LIZZETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
SUPERVISOR
Authorized Official Telephone Number:
787-662-2232

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , 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)





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